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Cvs Health Prior Authorization Jobs (NOW HIRING)

3Y

Prior Authorization Lead

Manhattan, NY · On-site

$100K - $140K/yr

Prior Authorizations Lead At 3Y Health, we are building AI-driven software to empower healthcare providers and solve the overwhelming administrative complexity that consumes 40% of the industry ...

3Y

Prior Authorization Lead

New York, NY · On-site

$100K - $140K/yr

About Us At 3Y Health, we are building AI-driven software to empower healthcare providers and solve ... About the Role We are seeking a Prior Authorizations Lead to design, manage, and scale 3Y Health ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$16.25 - $21.50/hr

Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process. We offer competitive wages based on experience and up to 3 ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$17 - $22.75/hr

Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process. We offer competitive wages based on experience and up to 3 ...

Curant Health

Prior Authorization Specialist

Smyrna, GA · On-site

$17.50 - $23.50/hr

As a Curant Health employee, your role is to deliver on that vision every day by delivering ... The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers ...

BlinkRx

Prior Authorization Specialist

Pittsburgh, PA · On-site

$17.50 - $23.25/hr

This is your opportunity to join a health-tech enterprise focused on making medications more ... Identify the correct prior authorization form required for the patient's insurance provider

Curant Health

Prior Authorization Specialist

Smyrna, GA · On-site

$18 - $24/hr

As a Curant Health employee, your role is to deliver on that vision every day by delivering ... The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers ...

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How much do cvs health prior authorization jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for cvs health prior authorization in the United States is $20.89, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.08 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Cvs Health Prior Authorization position, and why are they important?

To thrive as a CVS Health Prior Authorization specialist, you need a thorough understanding of insurance processes, medical terminology, and healthcare regulations, often backed by experience in pharmacy, nursing, or healthcare administration. Familiarity with pharmacy benefit management (PBM) systems, electronic prior authorization platforms, and relevant software such as Microsoft Office is critical. Excellent attention to detail, communication skills, and the ability to multitask under pressure are key soft skills for this role. These competencies ensure timely and accurate processing of medication authorizations, directly impacting patient care and satisfaction.

What is a CVS Health Prior Authorization job?

A CVS Health Prior Authorization job involves reviewing medication requests from healthcare providers to determine if they meet insurance coverage criteria. Employees in this role assess prior authorization requests, verify patient information, and apply clinical guidelines to ensure appropriate medication use. They may also communicate with healthcare professionals and patients regarding approvals or denials. This position requires attention to detail, knowledge of insurance policies, and strong customer service skills.

What are the typical daily responsibilities of a CVS Health Prior Authorization specialist?

As a CVS Health Prior Authorization specialist, your daily tasks usually involve reviewing prescription requests, verifying insurance coverage, and working with healthcare providers to ensure that required documentation is complete. You will communicate regularly with physicians' offices, insurance companies, and patients to clarify information and expedite approvals or denials. The role often requires managing multiple cases at once and adhering to tight deadlines, making strong organizational skills essential. Collaboration with pharmacists and claims teams is also common, ensuring that patients receive medications promptly and in line with compliance standards.

More about Cvs Health Prior Authorization jobs
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Cvs Health Prior Authorization jobs near you
Infographic showing various Cvs Health Prior Authorization job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $43,459 per year, or $20.9 per hour.

Prior Authorization Lead

3Y

Manhattan, NY • On-site

$100K - $140K/yr

Other

This job post has expired today. Applications are no longer accepted.

Job description

Prior Authorizations Lead

At 3Y Health, we are building AI-driven software to empower healthcare providers and solve the overwhelming administrative complexity that consumes 40% of the industry's revenue. Our end-to-end platform unlocks opportunities for clinician entrepreneurs, enabling medical professionals to launch, run, and grow private practices. By supporting these independent practices with the latest AI and automation, we're helping providers reclaim their time, build thriving businesses, and deliver better outcomes for their communities. 3Y Health is backed by over $200M from top-tier investors including Founders Fund, General Catalyst, Softbank, and 8VC.

We are seeking a Prior Authorizations Lead to design, manage, and scale 3Y Health's prior authorization operations. The ideal candidate will be an operational problem-solver who thrives on efficiency and loves turning complexity into clarity. This role requires a strategic yet hands-on operator who can build scalable systems, streamline workflows, and ensure timely, accurate approvals for our clinician partners across multiple specialties.

As the Prior Authorizations Lead, you will own the end-to-end authorization process from intake and submission to payer follow-up and resolution ensuring fast turnaround times and exceptional partner experience. You'll also partner closely with Product, RCM, and Operations teams to leverage automation and process design that reduce administrative burden for providers.

Responsibilities
  • Lead the end-to-end prior authorization process, including verification, documentation, submission, and follow-up with payers.
  • Build and optimize workflows that minimize turnaround times and maximize approval rates across multiple specialties.
  • Partner with Product and Engineering to identify automation opportunities and develop tools that reduce manual work.
  • Collaborate with RCM and Operations teams to ensure clean handoffs between authorizations, billing, and patient care coordination.
  • Develop and track KPIs to monitor authorization performance, identify bottlenecks, and continuously improve process efficiency.
  • Train and manage a growing team or vendor partners to ensure consistent execution and adherence to payer guidelines.
  • Maintain up-to-date knowledge of payer requirements, clinical criteria, and regulatory changes that impact authorization processes.
  • Build documentation, playbooks, and SOPs to support scaling into new states, payers, and clinical verticals.

Qualifications

  • Bachelor's degree required
  • 58 years of experience in healthcare operations, prior authorization management, or related RCM functions
  • Strong understanding of payer requirements, medical necessity documentation, and authorization workflows
  • Proven ability to lead cross-functional initiatives and manage complex, high-volume processes
  • Analytical and systems-oriented thinker with a track record of driving measurable improvements in turnaround times and accuracy
  • Experience with automation tools or EMR/EHR integrations a plus
  • Ability to work 5 days a week in our San Francisco or New York office with a fully in-person team

Compensation

The estimated salary range for this role is $100,000$140,000. Total compensation for this position may also include stock options. Note that total compensation for this position will be determined by each individual's relevant qualifications, work experience, skills, and other factors.

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