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Manager Prior Authorization Rn Jobs (NOW HIRING)

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party ... Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership.

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Medix

Prior Authorization Specialist

Phoenix, AZ · On-site

$20 - $24/hr

Manages and processes prior authorization requests submitted by clinics and Patient Care Coordinators * Accurately records and maintains detailed documentation of all findings and actions taken

Curant Health

Prior Authorization Specialist

Smyrna, GA

$18 - $24/hr

Curant Health, the leader in patient-centric chronic disease management via specialty pharmacy is ... Registered Pharmacy Technician Why Work for Us? We offer competitive pay, paid holidays, benefits ...

Alpaca Health

Prior Authorization Manager

New York, NY · On-site +1

Prior Authorizations Manager Responsibilities: * Work with our Prior Authorizations vendor to resolve complex authorization issues including coordinating with our providers, patients and payors * Be ...

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Manager Prior Authorization Rn information

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

As of Jul 15, 2026, the average hourly pay for manager prior authorization rn in the United States is $49.37, according to ZipRecruiter salary data. Most workers in this role earn between $38.22 and $55.77 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 cities are hiring for Manager Prior Authorization Rn jobs? Cities with the most Manager Prior Authorization Rn job openings:
What are the most commonly searched types of Prior Authorization Rn jobs? The most popular types of Prior Authorization Rn jobs are:
What states have the most Manager Prior Authorization Rn jobs? States with the most job openings for Manager Prior Authorization Rn jobs include:
Manager Prior Authorization Rn jobs near you

Prior Authorization Coordinator

Burgess Information Systems, Inc.

Hollywood, FL

$21 - $23/hr

Full-time

Posted 11 days ago

Job description

Status: Hourly, Non-Exempt

Hourly Rate: $21.00 - $23.00

Location: Onsite, Miramar, FL

JOB RESPONSIBILITIES

  • Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored patient support programs, utilizing payer portals, electronic submission platforms, fax, and telephonic outreach to facilitate timely access to therapy.
  • Serve as a central coordination point between prescribers, specialty pharmacies, payers, and internal HUB teams to ensure seamless progression from benefits investigation through authorization approval and therapy initiation.
  • Conduct comprehensive benefits verification and coverage analysis to identify prior authorization requirements, payer restrictions, and potential access barriers; initiate and track PA submissions accordingly.
  • Submit accurate and complete prior authorization requests, including all required clinical documentation, and perform proactive follow-up with payers to expedite determinations and minimize delays in therapy access.
  • Partner closely with provider offices to obtain clinical information, clarify prescribing intent, and support the development and submission of first-level appeals, reconsiderations, and medical exception requests.
  • Collaborate cross-functionally with HUB teams including reimbursement, copay assistance, patient assistance programs (PAP), and specialty pharmacy partners to remove financial and administrative barriers to treatment.
  • Maintain detailed, compliant documentation of all case activities, payer interactions, and authorization statuses within the HUB CRM system to ensure transparency, reporting accuracy, and audit readiness.
  • Evaluate authorization outcomes to determine next steps, including appeals, bridge program eligibility, or alternative access solutions in alignment with manufacturer program.
  • Monitor therapy status and coordinate prior authorization renewals or reauthorizations to support continuity of care and prevent treatment interruptions.
  • Ensure adherence to all regulatory and privacy requirements, including the Health Insurance Portability and Accountability Act (HIPAA), as well as manufacturer program policies and standard operating procedures.
  • Deliver a high-touch customer experience by maintaining professional, empathetic communication with patients and healthcare providers throughout the access
  • Support onboarding and ongoing training of team members; contribute to knowledge sharing and best practices within the HUB environment.
  • Demonstrate strong knowledge of payer landscapes, specialty pharmacy workflows, and manufacturer HUB services, ensuring alignment with program-specific requirements.
  • Perform additional duties as needed to support patient access objectives and overall HUB program success.


QUALIFICATIONS AND REQUIREMENTS
Previous Experience:

  • Previous experience in managing prior authorizations or working knowledge of the prior authorization process is highly preferred.
  • Strong understanding of medical terminology, insurance plans and authorization.
  • Bilingual English/Spanish is a plus.
  • Minimum 3 years of pharmacy or healthcare experience.
  • Ability to manage cases from multiple clientele programs and follow program business.
  • Proficiency with data entry functions, Microsoft applications, and hands-on computer skill.
  • Ability to work independently and on a team.
  • Excellent communication, problem solving and customer service.
  • Strong organizational /interpersonal skills; attention to detail and the ability to multitask.
  • Ability to use multiple PC monitors and navigate through several software systems effectively.

Education:

  • High School Graduate required, College degree preferred.
  • State Pharmacy Technician registration or PTCB National Certification preferred.

Physical Demands:

  • Requires sitting, standing, and occasional light lifting.

This is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our website for more information about our benefits list.

ProMod Rx will never ask for a financial commitment from an applicant, as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our official recruitment team at HumanResources@procarerx.com.

ProMod Rx is an Equal Opportunity Employer.