Licensed Vocational Nurse-LPN

This a Full Remote job, the offer is available from: Rhode Island (USA) 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? • Health Benefits • Referral Program • Excellent growth and advancement opportunities This offer from "ICONMA" has been enriched by Jobgether.com and got a 72% flex score.