Offer summary

Qualifications:

Active, unencumbered LPN/LVN license in North Carolina, Minimum 2 years of experience in reviewing and processing prior authorizations, Proficiency in computer skills, including MS Office and telephony programs, High School Diploma or GED required..

Key responsabilities:

Follow prior authorization procedures to ensure compliance with quality standards and regulations.

Participate in quality assurance activities and review work instructions regularly.

Collaborate with team members and healthcare professionals on prior authorization tasks.

Utilize clinical skills to support documentation research and prior authorization determinations.

Job description

Our Client, a Retail Pharmacy company, is looking for a Licensed Vocational Nurse to work from home.

Responsibilities:

Follow all prior authorization procedures to meet business quality standards and ensuring the operational unit is complying with regulatory requirements and accreditation standards.
Participates in quality assurance activities on ongoing basis, including but not limited to reviewing work instructions and job aids regularly.
Collaborate with representatives on the prior authorization team, pharmacists, clinical colleagues, healthcare professionals, clients, leaders, and team members.
Complete other prior authorization assignments as delegated by the leadership team.
Utilization of clinical and problem-solving skills to support the research of documentation, communication of medical services, and prior authorization determinations.
Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment.
This position involves sedentary work with extended periods of sitting, talking on the telephone, using multiple programs on multiple computer screens, and keyboarding.

Requirements:

Hold and maintain an active, unencumbered LPN/LVN license; North Carolina licensure
Proficiency with computer skills which include multitasking, navigating multiple systems, and keyboarding.
Experience using MS Office, other Windows-based computer applications, web based processing and telephony programs.
Minimum 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical office or Pharmacy Benefits Manager (PBM)
Verifyable High School Diploma or GED Required

Why Should You Apply?

Health Benefits
Referral Program
Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

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