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Full Time Prior Authorization Rn Jobs in Miami, FL

Leon Health Plan

Concurrent Review Nurse

Doral, FL · On-site

Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...

Aveanna Healthcare

Registered Nurse (RN)

Hollywood, FL · On-site

Flexible scheduling- full-time, part-time, or PRN. Days, nights, and weekend shifts- we will work ... Six months prior hands-on nursing experience preferred but not required * Must have reliable ...

Medi Nurse Home Care

Registered Nurse

Aventura, FL · On-site

$70K - $85K/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

The Lakes Home Care

Registered Nurse (RN)

Miami, FL · On-site

$15/wk

One year prior Registered Nurse (RN) experience preferred. The Lakes Benefits: * Competitive salary * Flexible work hours where you create your own schedule You can expect a 1 patient: 1 nurse ratio ...

The Lakes Home Care

Registered Nurse (RN)

Miami, FL · On-site

$15/wk

One year prior Registered Nurse (RN) experience preferred. The Lakes Benefits: * Competitive salary * Flexible work hours where you create your own schedule You can expect a 1 patient: 1 nurse ratio ...

Medi Nurse Home Care

Registered Nurse

Kendall, FL · On-site

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Kendall, FL · On-site

$70K - $85K/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Aventura, FL

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Doral, FL · On-site

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Homestead, FL · On-site

$70K - $85K/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Pembroke Pines, FL · On-site

$50/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Oakland Park, FL · On-site

$50/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Weston, FL · On-site

$50/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Oakland Park, FL · On-site

$50/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

Medi Nurse Home Care

Registered Nurse

Miramar, FL · On-site

$50/hr

Our home health agency is currently seeking a full-time RN to join our team. As an RN with our agency, you will have the opportunity to work with a diverse patient population and provide care in the ...

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Showing results 21-40

All JobsPrior Authorization Rn JobsFull Time Prior Authorization Rn JobsFull Time Prior Authorization Rn Jobs in Miami, FL

Full Time Prior Authorization Rn information

See Miami, FL salary details

$7

$40

$68

How much do full time prior authorization rn jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for full time prior authorization rn in Miami, FL is $40.40, according to ZipRecruiter salary data. Most workers in this role earn between $30.10 and $47.84 per hour, depending on experience, location, and employer.

What is a full time prior authorization RN?

Full Time Prior Authorization Registered Nurses (RNs) are healthcare professionals who work primarily in administrative roles to review and evaluate medical service requests. Their main responsibility is to determine if specific treatments, medications, or procedures meet insurance company criteria for coverage before they are provided to patients. They use their clinical knowledge to assess medical necessity and ensure compliance with healthcare policies and guidelines. These nurses typically interact with physicians, insurance companies, and patients to manage authorizations and appeals, ensuring that care is both appropriate and covered under a patient’s health plan.

What are some typical challenges faced by full time prior authorization RNs, and how can they be managed?

Full Time Prior Authorization RNs often encounter challenges related to navigating complex insurance guidelines, managing high caseloads, and ensuring timely communication between healthcare providers and payers. Staying organized, keeping up-to-date with frequently changing insurance policies, and developing strong collaboration skills with both clinical and administrative teams are key to success in this role. Leveraging electronic health records and standardized workflows can also help streamline the authorization process and reduce delays for patients.

What are the key skills and qualifications needed to thrive as a full time prior authorization RN, and why are they important?

To thrive as a Full Time Prior Authorization RN, you need a strong nursing background (active RN license), in-depth knowledge of medical terminology, and experience with insurance processes or utilization review. Familiarity with prior authorization software, electronic health records (EHRs), and insurance payer portals is typically required. Exceptional attention to detail, critical thinking, and strong communication skills help you effectively evaluate medical necessity and advocate for patient care. These abilities ensure timely, accurate authorizations, reduce claim denials, and promote optimal patient outcomes.

What is the difference between Full Time Prior Authorization Rn vs Medical Coder?

AspectFull Time Prior Authorization RnMedical Coder
CredentialsRN license, certification in case management or utilization reviewCertification in coding (CPC, CCS), knowledge of medical coding systems
Work EnvironmentHealthcare facilities, insurance companies, utilization review departmentsMedical offices, hospitals, insurance companies, coding agencies
Job FocusReviewing and authorizing medical procedures and treatmentsTranslating medical records into standardized codes for billing

While both roles require healthcare knowledge, the Full Time Prior Authorization RN focuses on evaluating medical necessity for treatments, whereas Medical Coders translate medical documentation into codes for billing. Both are essential in healthcare administration but serve different functions within the patient care and billing process.

What are the most commonly searched types of Prior Authorization Rn jobs in Miami, FL?

The most popular types of Prior Authorization Rn jobs in Miami, FL are:

Full Time Prior Authorization Rn jobs near you
Infographic showing various Full Time Prior Authorization Rn job openings in Miami, FL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 95% In-person, and 5% Remote job distribution, with an average salary of $84,040 per year, or $40.4 per hour.

Concurrent Review Nurse

Leon Health Plan

Doral, FL • On-site

Full-time

Posted 24 days ago

Job description

Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care. This is achieved through the review of inpatient admissions, outpatient precertification, and prior authorization requests, using established medical policies, evidence-based guidelines, and managed care standards.

Essential Duties and Responsibilities
  • Lead, train, and support both clinical and non-clinical staff in accordance with Leon Health's policies and procedures to ensure efficient and effective performance.
  • Monitor and respond to incoming calls and written inquiries from members, providers, and internal departments.
  • Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate prioritization.
  • Enter service requests and determination data into the appropriate systems in compliance with regulatory requirements and organizational policies.
  • Review clinical documentation for precertification and concurrent (ongoing) reviews.
  • Perform on-site and/or telephonic reviews to determine the appropriateness of inpatient and outpatient care settings, using medical policies, CMS guidelines, and industry standards.
  • Conduct medical and behavioral health (BH) reviews for pre- and post-service authorization requests.
  • Issue authorizations for inpatient admissions, outpatient services, and post-service requests to providers, facilities, and members as applicable.
  • Refer complex cases to a Medical Director or Behavioral Health Practitioner when additional clinical evaluation is required.
  • Ensure all documentation is complete, accurate, and clearly supports authorization decisions.
  • Process denial determinations in compliance with regulatory standards and internal policies.
  • Maintain up-to-date census reports, daily notes, and authorization records, including tracking admissions and discharges.
  • Collaborate with healthcare providers to obtain necessary clinical documentation for medical necessity determinations.
  • Work with providers to proactively identify discharge needs and assist in care planning.
  • Facilitate smooth care transitions across the healthcare continuum by coordinating with facilities and the Care Management team.
Education
  • Bachelor's degree in Nursing required
Experience
  • Minimum of two (2) years of experience in clinical review or utilization management
Language Skills
  • Bilingual in English and Spanish (required)

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