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Manager Prior Authorization Rn Jobs in Illinois (NOW HIRING)

Hopedale MC

Prior Authorization Specialist

Hopedale, IL · On-site

$18 - $23/hr

Prior Authorization Specialist, Full-time $18-$23/hour HMC Offers: * Tuition Reimbursement ... Other duties as assigned by the Patient Access Manager. Job Requirements : * Minimum of high school ...

Onco360

Pharmacy Prior Authorization Specialist

Woodridge, IL · On-site +1

$20.25 - $26.25/hr

Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...

BJC

Prior Authorization Rep - Part Time

Belleville, IL

$38.90K - $53.40K/yr

Our testing is supervised by a registered polysomnographic tech and interpreted by a physician with ... resources to help you manage your physical, emotional, social and financial well-being.

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Manager Prior Authorization Rn information

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

AspectManager Prior Authorization RnNurse Case Manager
CredentialsRN license, certifications in prior authorizationRN license, case management certification
Work EnvironmentUtilization review, insurance companies, healthcare administrationPatient advocacy, care coordination, healthcare facilities
Employer & IndustryInsurance companies, healthcare organizationsHospitals, clinics, insurance providers

The Manager Prior Authorization Rn primarily focuses on reviewing and approving insurance claims for medical procedures, ensuring compliance with policies. Nurse Case Managers coordinate patient care, advocate for patients, and manage treatment plans. While both roles require RN licensure and healthcare knowledge, the Manager Prior Authorization Rn emphasizes administrative review, whereas Nurse Case Managers are more involved in direct patient care coordination.

What are the most commonly searched types of Prior Authorization Rn jobs in Illinois? The most popular types of Prior Authorization Rn jobs in Illinois are:
What cities in Illinois are hiring for Manager Prior Authorization Rn jobs? Cities in Illinois with the most Manager Prior Authorization Rn job openings:
Manager Prior Authorization Rn jobs near you
Prior Authorization Specialist

Prior Authorization Specialist

CareMed Specialty Pharmacy

Woodridge, IL • On-site, Remote

$23 - $25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

Pharmacy Prior Authorization Specialist – CareMed Specialty Pharmacy
Woodridge, IL | Full-Time | Starting at $23.00/hr and up
Sign-On Bonus: $5,000 for employees starting before July 31, 2026.
Join a mission-driven team making a difference in the lives of cancer patients.
CareMed Specialty Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Woodridge, IL. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.
Company Benefits
  • Medical; Dental; Vision
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Quarterly Incentive Bonus
  • Paid Volunteer Day
  • Referral Incentive Program
  • Company Paid Life Insurance; and Short/Long-Term Disability
Why Join Us?
  • A career with purpose: Help patients access life-saving medications.
  • Supportive culture: We value teamwork, respect, integrity, and passion.
  • Growth opportunities: We invest in your professional and personal development.
What You’ll Do
The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.
How You’ll Do This
  • Manage prior authorization requests and appeals with insurance carriers.
  • Collaborate with physicians, pharmacists, and other departments.
  • Ensure HIPAA compliance while handling sensitive patient information.
  • Maintain accurate documentation of authorization details.
  • Proactively monitor and renew expiring authorizations.
What You Bring
Required:
  • High School Diploma or GED
  • 1+ years of pharmacy or prior authorization experience
  • Registration with Board of Pharmacy (as required by state law)
  • Strong communication, organizational, and customer service skills
  • Self-motivated, organized, detail-oriented, and adaptable to changing priorities
  • Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds
Preferred:
  • Associate degree or Certified Pharmacy Technician (PTCB)
  • 3+ years of experience in pharmacy or prior authorizations
  • Specialty pharmacy experience
Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.
#Company Values: Teamwork, Respect, Integrity, Passion

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