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Prior Auth Jobs in California (NOW HIRING)

Saransh Inc

Life Sciences Business Architect

Valencia, CA · On-site

$61.50 - $80/hr

Required Skills: * 7-12 years in Life Sciences, Healthcare, or Payer/Provider domains (with 3-5 years in Pre-Auth or Utilization Management). * Deep understanding of prior authorization workflows ...

Care Navigators On Demand

$39 - $45/hr

Prior Authorization RN Case Manager Granada Hills, CA Full-Time Direct Hire Description Therole of ... auth coordinator team, high-risk nurse casemanagers, inpatient nurse case managers, medical ...

January

Head of Partnerships

Menlo Park, CA

$300K/yr

Your initial focus will be health systems, providers, longevity clinics, and strategic platform partners across clinical workflow, ambient AI, prior auth, and care operations. Over time, you will ...

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Showing results 21-40

All JobsPrior Auth JobsPrior Auth Jobs in California

Prior Auth information

What is the difference between Prior Auth vs Medical Billing Specialist?

AspectPrior AuthMedical Billing Specialist
Required CredentialsKnowledge of insurance policies, certifications varyCertification often preferred, knowledge of billing codes
Work EnvironmentHealthcare offices, insurance companiesMedical offices, billing companies
Employer & Industry UsageUsed in healthcare to authorize proceduresUsed to process and submit medical claims
Common Search & ComparisonYesYes

Prior Auth involves obtaining approval from insurance companies before procedures, while Medical Billing Specialists handle the billing process after services are provided. Both roles are essential in healthcare administration but focus on different stages of patient care and reimbursement.

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Prior Auth jobs near you
Infographic showing various Prior Auth job openings in California as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 2% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution.

Medical Director - Prior Authorization - CA licensure required - Remote

UnitedHealth Group

Torrance, CA • On-site, Remote

$248K - $373K/yr

Full-time

Retirement

Posted 22 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

189th of 887 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 4 industry leader.
This position will support the growing Prior Auth program which covers the California Market. The scope of this role will include Prior Authorization for Medicare Advantage members focusing on high value procedures such as Myocardial SPECT, PET scans, DME/Home Ventilator, Genetic Testing, and many more. Additionally, the team handles UM functions for the California Market.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Work to improve quality and promote evidence-based medicine
  • Prior authorization, utilization management and claims review cases for patients
  • Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
  • Support initiatives that enhance quality throughout our national network
  • Ensure the right service is provided at the right time for each member
  • Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review
  • Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • MD or DO degree
  • Active, unrestricted physician state license in CA
  • Current board certification through the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA)
  • 5+ years of clinical practice experience post residency
  • Proven solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

Preferred Qualifications:
  • Hands-on utilization and/or quality management experience
  • Prior Authorization experience
  • Project management or active project participation experience
  • Substantial experience in using electronic clinical systems
  • Licensure in New Mexico, Utah, Nevada, or Arizona (or willing and able to obtain)

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation for this specialty generally ranges from $248,500.00 to $373,000.00. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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