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Licensed Vocational Nurse-LPN

ICONMA

Key Facts

Remote From: 
Rhode Island (USA)
Category:  Nurse
Full time
Mid-level (2-5 years)
English

Other Skills

  • •
    Critical Thinking
  • •
    Detail Oriented
  • •
    Computer Literacy
  • •
    Multitasking
  • •
    Computer Keyboards
  • •
    Organizational Skills
  • •
    Communication
  • •
    Time Management
  • •
    Problem Solving

Roles & Responsibilities

  • Active, unrestricted LPN/LVN license
  • Minimum 2+ years of recent prior authorization experience in a PBM, MDO, or clinical setting
  • Experience reviewing and applying clinical criteria and supporting documentation for PAs
  • Experience using CoverMyMeds or similar authorization platforms

Requirements:

  • Manage inbound and outbound calls while maintaining productivity, quality, and service level expectations
  • Review and process complex prior authorization requests using clinical criteria and supporting documentation
  • Navigate multiple systems, tools, and communication platforms simultaneously with speed and accuracy
  • Communicate clearly and professionally with team members, pharmacists, providers, and leadership

Job description

Our Client, a Retail Pharmacy company, is looking for a Licensed Vocational Nurse-LPN for their Remote location.
 
Responsibilities:
  • Manage inbound and outbound calls while maintaining productivity, quality, and service level expectations
  • Review and process complex prior authorization requests using clinical criteria and supporting documentation
  • Navigate multiple systems, tools, and communication platforms simultaneously with speed and accuracy
  • Review chart notes, claims history, and prior authorization history to make accurate determinations
  • Submit complete and accurate documentation to support determinations and avoid unnecessary delays
  • Identify cases requiring escalation and refer appropriately
  • Demonstrate critical thinking and problem-solving when information is unclear or incomplete
  • Apply internal workflows, job aids, and policies correctly and consistently
  • Adapt quickly to changing priorities, processes, and clinical criteria
  • Communicate clearly and professionally with team members, pharmacists, providers, and leadership
  • Ask questions and seek clarification when needed to ensure accuracy
  • Maintain attention to detail while processing high volumes of work efficiently
  • Participate in quality assurance activities and apply feedback for continuous improvement
  • Perform work in a sedentary, desk-based environment requiring prolonged sitting, typing, and screen time
  • Maintain consistent attendance, productivity, and adherence to scheduled work hours
 
Requirements:
  • Active, unrestricted LPN/LVN license
  • Minimum 2+ years of recent prior authorization experience in a PBM, MDO, or clinical setting
  • Experience reviewing and applying clinical criteria and supporting documentation for PAs
  • Experience using CoverMyMeds or similar authorization platforms
  • Familiarity with chart notes, claims history, and insurance requirements
  • Technical Skills
  • Strong computer proficiency across multiple systems (Outlook, Teams, Word, Excel, etc.)
  • Ability to multitask across multiple monitors and applications simultaneously
  • Advanced keyboarding skills, with the ability to type quickly and accurately
  • Behavioral and Work Style Requirements
  • Proven ability to work in a fast-paced, high-production, metrics-driven environment
  • Strong attention to detail while maintaining speed and accuracy
  • Ability to learn quickly and work independently with limited guidance
  • Strong time management and organizational skills in a remote setting
  • Ability to remain focused and productive while working independently for full shifts
  • Comfortable working in a structured, highly monitored environment with performance metrics
  • Strong written and verbal communication skills, including the ability to clearly articulate clinical information and medication names
  • Ability to receive, apply, and act on real-time feedback
  • Preferred Qualifications
  • 3+ years of prior authorization experience
  • Experience in a specialty medical office or with specialty medications
  • Broad clinical background across multiple disease states
  • Previous call center or high-volume clinical processing experience
  • What Makes Someone Successful in This Role
  • Successful team members consistently demonstrate:
  • Ability to work under pressure while maintaining accuracy and productivity
  • Demonstrated ownership, reliability, and accountability for performance
  • Resourcefulness—able to locate and interpret information independently before escalating
  • Confidence to ask questions, seek clarification, and speak up when unsure
  • Ability to quickly learn new medications, disease states, and clinical criteria
  • Strong multitasking ability across systems, workflows, and communication tools
  • Excellent attention to detail combined with processing speed
  • Resilience and adaptability—able to adjust to frequent changes and challenges
  • Ability to remain focused and productive despite obstacles, system issues, or changing priorities
  • Ability to work successfully within a structured, performance-driven environment
  • Strong self-awareness and coachability, including the ability to accept and apply feedback
  • Accountability for personal performance, learning, and development
  • Ability to work independently in a distraction-free remote environment
  • Work Environment & Expectations
 
Why Should You Apply?  
 
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