Our Client, a Retail Pharmacy company, is looking for a Nurse Case Manager I - Case Management Specialist for their Remote location. Responsibilities: + Prior Authorizations, Coordination with PCP and Specialty providers, Condition Management information and education, Medication management, Community Resources and supports) + Evaluation of health and social indicators + Identifies and engages barriers to achieving optimal member health. + Uses discretion to apply strategies to reduce member risk. + Presents cases at case conferences for multidisciplinary focus to benefit overall member management. + Facilitates overall care coordination with the care team to ensure member achieves optimal wellness within the confines of the member’s condition(s) and abilities to self-manage. + Coordinates resources, assists with securing DME, and helps to ensure timely physician follow-up. + Understands Payer/Plan benefits, policies, procedures, and can articulate them effectively to providers, members, and other key personnel. + Updates the Care Plan for any change in condition or behavioral health status. + Provide support to members in transitions of care + Responsible for interacting with low stratification members via phone calls, coordinating care, completing, reviewing, and updating assessments and care plans that address problems, goals, and interventions. Based on assessments and claims data creates a care plan for members to follow 70% + Participate as a member of the Care Team during Interdisciplinary Team meetings to discuss the member’s health care needs, barriers to care and explore better outcomes for the member 20% + Identify and link members with health plan benefits and community resources 5% + Perform administrative work to maintain skills needed for job duties 5% 5% Requirements: + Verifiable High School Diploma or GED Required + 2 years LPN Nursing exp, preferred 3 + years’ experience. + Regular and reliable attendance + Familiar with community resources & services + Strong organizational skills + Works independently. + Maintains professional relationships with the members we serve as well as colleagues. + Communicates effectively and professionally verbally and in writing. + Proficient with computer systems + Knowledgeable in Microsoft Office Software + Excellent customer service skills + Has a dedicated home work space + HS or equivalent, must be licensed LPN. 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.