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Evening Prior Authorization Nurse Jobs (NOW HIRING)

WomanCare Centers

Prior Authorization Nurse

Norfolk, VA · On-site

$25 - $31/hr

WomanCare Centers Prior Authorization Nurse We are a busy, patient-centered OB/GYN outpatient practice dedicated to providing compassionate, comprehensive care to women at every stage of life. Our ...

OneOncology LLC

Prior Authorization Specialist

Huntsville, AL · On-site

$17.75 - $23.75/hr

Communicate with Physicians and RN's regarding treatment. * Check previous patient treatment with current treatment to ensure insurance payments and prior authorizations have been entered/approved.

Care Navigators On Demand

$39 - $45/hr

Prior Authorization RN Case Manager Granada Hills, CA Full-Time Direct Hire Description Therole of the Prior Authorization Nurse Case Manager (PACM) is to promotethe quality and cost effectiveness of ...

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How much do evening prior authorization nurse jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for evening prior authorization nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What is the difference between Evening Prior Authorization Nurse vs Evening Case Manager?

AspectEvening Prior Authorization NurseEvening Case Manager
CredentialsRN license, certifications in case management or utilization reviewRN or social work license, case management certification often preferred
Work EnvironmentHospitals, insurance companies, healthcare facilities during evening shiftsHospitals, insurance companies, healthcare organizations during evening hours
Primary FocusReviewing and authorizing medical procedures and treatmentsCoordinating patient care and discharge planning

While both roles involve healthcare coordination and may require similar certifications, the Evening Prior Authorization Nurse primarily focuses on reviewing and approving medical procedures during evening shifts. In contrast, the Evening Case Manager concentrates on managing patient care plans and discharge processes. Both roles are vital in healthcare settings and often work during similar hours, but their core responsibilities differ.

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Evening Prior Authorization Nurse jobs near you
Infographic showing various Evening Prior Authorization Nurse job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

Prior Authorization Nurse

Jefferson County Health Center

Fairfield, IA • On-site

Full-time

Posted 9 days ago

Key responsibilities

  • Review clinical documentation to determine medical necessity for requested services.

  • Submit prior authorization requests to insurance companies using payer-specific portals and Epic workflows.

  • Track and follow up on pending authorizations to ensure timely responses.

Jefferson County Health Center rating

9.1

Company rating: 9.1 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

14th of 1,065 rated hospitals

Job description

POSITION OVERVIEW (non-exempt):

The Prior Authorization Nurse plays a critical role in ensuring timely and accurate authorization of medical services across multiple specialties. This position serves as a liaison between providers, patients, and insurance companies to facilitate timely access to care while ensuring compliance with payer guidelines. The nurse utilizes clinical knowledge and judgment to evaluate medical necessity, gather supporting documentation, verifying insurance requirements and submitting prior authorization requests for multiple specialties. Working collaboratively with physicians, clerical staff, and other departments, the Prior Authorization Nurse helps streamline workflows, reduce delays in care, and optimize reimbursement.

QUALIFICATIONS:

  • Current Registered Nurse (RN) license in IA preferred. Licensed Practical Nurse (LPN) applicants with relevant prior authorization experience will also be considered
  • 2+ years of clinical nursing experience
  • Prior experience in utilization review, case management, or prior authorization preferred
  • Strong knowledge of payer policies and clinical criteria (e.g., InterQual, MCG)
  • Experience in one or more of the following specialties: oncology, radiology, infusion therapy, pain management procedures or surgical services
  • Experience with Microsoft Office, Excel and other web-based programs including CoverMyMeds
  • Excellent communication, organizational and time management skills

ACCOUNTABILITY: 

Reports to the Prior Authorization Manager and Revenue Cycle Director

DIRECT REPORTS:

None

POSITION-SPECIFIC REQUIREMENTS:

  • Review clinical documentation to determine medical necessity for requested services.
  • Submit prior authorization requests to insurance companies using payer-specific portals and Epic workflows.
  • Communicate with providers to obtain additional documentation or clarify orders as needed.
  • Track and follow up on pending authorizations to ensure timely responses.
  • Document all authorization activity in the electronic health record (Epic).
  • Collaborate with other team members to ensure complete and accurate submissions.
  • Stay current with payer guidelines, authorization requirements, and regulatory changes.
  • Escalate denials or delays to appropriate clinical or administrative leadership.
  • Coordinate and schedule peer-to-peer (P2P) reviews between providers and payers to address clinical denials.
  • Submit formal appeals for denied services, ensuring compliance with payer-specific guidelines and timelines
  • Participate in process improvement initiatives to streamline authorization workflows.
  • Perform additional responsibilities as requested by leadership to support departmental goals and hospital operations

WORK ENVIRONMENT:

  • Works in a well-illuminated, climate-controlled environment
  • May come in contact with hazardous chemical or treatment modalities
  • Possibility exists of exposure to communicable diseases
  • Involvement in inpatient care may result in unavoidable work-related illness or injury
  • Work environment is comfortable, with minimal exposure to physical hazards
  • Moderate to loud noise environment when machines/equipment in use
  • Involvement in checking in/moving of supplies may result in unavoidable work-related injury
  • Must be constantly alert for patient/family emergency situations

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