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Manager Prior Authorization Rn Jobs in Madison, WI

The Registered Nurse provides high-quality clinical support across all phases of patient care ... Transcribe and transmit prescriptions and manage prior authorizations * Perform phlebotomy ...

The Registered Nurse provides high-quality clinical support across all phases of patient care ... Transcribe and transmit prescriptions and manage prior authorizations * Perform phlebotomy ...

The Registered Nurse provides high-quality clinical support across all phases of patient care ... Transcribe and transmit prescriptions and manage prior authorizations * Perform phlebotomy ...

RN - Ambulatory, Nephrology

Madison, WI ยท On-site

$37.31 - $55.97/hr

... prior authorization and other duties related to support the general Nephrology and Polycystic ... Work in a fast-paced team-oriented environment, managing a wide variety of tasks including new ...

... prior authorization and other duties related to support the general Nephrology and Polycystic ... Work in a fast-paced team-oriented environment, managing a wide variety of tasks including new ...

... prior authorization and other duties related to support the general Nephrology and Polycystic ... Work in a fast-paced team-oriented environment, managing a wide variety of tasks including new ...

... prior authorization and other duties related to support the general Nephrology and Polycystic ... Work in a fast-paced team-oriented environment, managing a wide variety of tasks including new ...

The SUD RN supports substance use disorder practitioners and their patients by managing ... prior authorizations, referrals, labs or other orders; and coordinating with other healthcare ...

... Clinic Manager. The RN utilizes the nursing process (assessment, planning, intervention, and ... prior authorizations for medical care and treatment. * Administers medication by all routes ...

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Manager Prior Authorization Rn information

See Madison, WI salary details

$25

$49

$85

How much do manager prior authorization rn jobs pay per hour?

As of May 30, 2026, the average hourly pay for manager prior authorization rn in Madison, WI is $49.74, according to ZipRecruiter salary data. Most workers in this role earn between $38.51 and $56.20 per hour, depending on experience, location, and employer.

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 Madison, WI? The most popular types of Prior Authorization Rn jobs in Madison, WI are:
What cities near Madison, WI are hiring for Manager Prior Authorization Rn jobs? Cities near Madison, WI with the most Manager Prior Authorization Rn job openings:

Remote Prior Authorization Pharmacist

Pharmacy Careers

Madison, WI โ€ข Remote

$58.75 - $70.50/hr

Other

Posted 6 days ago


Job description

Remote Prior Authorization Pharmacist - Work From Home in Managed Care
A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.
Key Responsibilities

  • Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
  • Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
  • Communicate approval/denial decisions clearly to providers and patients.
  • Collaborate with physicians, nurses, and medical directors on complex cases.
  • Document outcomes in compliance with health plan policies and CMS/state regulations.
  • Support process improvements to streamline workflow and turnaround times.


What You'll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
  • Skills: Excellent clinical review, documentation, and communication skills.

Why This Role?

  • Flexibility: 100% remote work from home with flexible scheduling options.
  • Impact: Directly influence patient access to safe and cost-effective medications.
  • Growth: Build specialized skills in utilization management and managed care.
  • Rewards: Competitive compensation, benefits, and career advancement opportunities.


About Us
We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.
Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.