Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina ...
Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina ...
Prior Authorization Nurse - RN
$37 - $39/hr
We are looking for a Prior Authorization Nurse to use clinical judgment and critical thinking as part of a comprehensive program to assist the CHP Care Management team and clients in their efforts to ...
Prior Authorization Nurse - RN
$37 - $39/hr
We are looking for a Prior Authorization Nurse to use clinical judgment and critical thinking as part of a comprehensive program to assist the CHP Care Management team and clients in their efforts to ...
Perform telephonic review of prior authorization requests for appropriate care and setting ... Associate's degree in Nursing. * Minimum of 2-5 years of clinical experience in acute setting * One ...
Perform telephonic review of prior authorization requests for appropriate care and setting ... Associate's degree in Nursing. * Minimum of 2-5 years of clinical experience in acute setting * One ...
Prior Authorization Nurse Case Manager (PACM) The role of the Prior Authorization Nurse Case Manager (PACM) is to promote the quality and cost effectiveness of medical care by applying clinical ...
Prior Authorization Nurse Case Manager (PACM) The role of the Prior Authorization Nurse Case Manager (PACM) is to promote the quality and cost effectiveness of medical care by applying clinical ...
This exciting opportunity will require a Prior Authorization Registered Nurse who can provide a high level of service and attention to their patients. If you are a seasoned Prior Authorization ...
This exciting opportunity will require a Prior Authorization Registered Nurse who can provide a high level of service and attention to their patients. If you are a seasoned Prior Authorization ...
... prior authorization/utilization review Preferred Education * Bachelor of Science in Nursing Preferred Licenses * N/A Preferred Certifications * N/A ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES ALL ...
... prior authorization/utilization review Preferred Education * Bachelor of Science in Nursing Preferred Licenses * N/A Preferred Certifications * N/A ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES ALL ...
... prior authorization/utilization review Preferred Education * Bachelor of Science in Nursing Preferred Licenses * N/A Preferred Certifications * N/A ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES ALL ...
... prior authorization/utilization review Preferred Education * Bachelor of Science in Nursing Preferred Licenses * N/A Preferred Certifications * N/A ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES ALL ...
Prior Authorization Nurse - Remote - AZ
Phoenix, AZ · On-site +1
... prior authorization/utilization review Preferred Education * Bachelor of Science in Nursing Preferred Licenses * N/A Preferred Certifications * N/A ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES ALL ...
Prior Authorization Nurse - Remote - AZ
Phoenix, AZ · On-site +1
... prior authorization/utilization review Preferred Education * Bachelor of Science in Nursing Preferred Licenses * N/A Preferred Certifications * N/A ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES ALL ...
Prior Authorization
$16.75 - $22.50/hr
General Summary The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to support timely patient care. This ...
Prior Authorization
$16.75 - $22.50/hr
General Summary The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to support timely patient care. This ...
Prior Authorization Temp Nurse Case Manager
Northridge, CA · On-site
$38 - $42/hr
Prior Authorization Temp Nurse Case Manager, RN Northridge, CA 4-Month Contract Assignment * Quick On-Boarding/Placement Process * Career Stepping Stone from Bedside Nursing to Case Management (acute ...
Prior Authorization Temp Nurse Case Manager
Northridge, CA · On-site
$38 - $42/hr
Prior Authorization Temp Nurse Case Manager, RN Northridge, CA 4-Month Contract Assignment * Quick On-Boarding/Placement Process * Career Stepping Stone from Bedside Nursing to Case Management (acute ...
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior ... Communicate with physicians, nurses, pharmacies, and other departments regarding authorization ...
Quick apply
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior ... Communicate with physicians, nurses, pharmacies, and other departments regarding authorization ...
$39 - $45/hr
Prior Authorization RN Case Manager Granada Hills, CA Full-Time Direct Hire Description Therole of the Prior Authorization Nurse Case Manager (PACM) is to promotethe quality and cost effectiveness of ...
$39 - $45/hr
Prior Authorization RN Case Manager Granada Hills, CA Full-Time Direct Hire Description Therole of the Prior Authorization Nurse Case Manager (PACM) is to promotethe quality and cost effectiveness of ...
Prior Authorization Department
Santa Ana, CA · On-site
$25/hr
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior ... Communicate with physicians, nurses, pharmacies, and other departments regarding authorization ...
Quick apply
Prior Authorization Department
Santa Ana, CA · On-site
$25/hr
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior ... Communicate with physicians, nurses, pharmacies, and other departments regarding authorization ...
Prior Authorization Department
Santa Ana, CA · On-site
$25/hr
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior ... Communicate with physicians, nurses, pharmacies, and other departments regarding authorization ...
Quick apply
Prior Authorization Department
Santa Ana, CA · On-site
$25/hr
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior ... Communicate with physicians, nurses, pharmacies, and other departments regarding authorization ...
Prior Authorization Department
$18.75 - $25/hr
... nurses, pharmacies, and other departments regarding authorization status and additional ... prior to scheduled services when required Maintain confidentiality of patient information in ...
Prior Authorization Department
$18.75 - $25/hr
... nurses, pharmacies, and other departments regarding authorization status and additional ... prior to scheduled services when required Maintain confidentiality of patient information in ...
Prior Authorization Specialist
$17 - $22.75/hr
Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process. We offer competitive wages based on experience and up to 3 ...
Prior Authorization Specialist
$17 - $22.75/hr
Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process. We offer competitive wages based on experience and up to 3 ...
Prior Authorization Specialist
Auburn, NY · On-site
$18 - $24.50/hr
The prior authorization specialist is responsible for coordinating all aspects of the prior ... Work with supervisors or nurse managers to confirm treatment plans meet medical necessity criteria.
Prior Authorization Specialist
Auburn, NY · On-site
$18 - $24.50/hr
The prior authorization specialist is responsible for coordinating all aspects of the prior ... Work with supervisors or nurse managers to confirm treatment plans meet medical necessity criteria.
Prior Authorization Specialist
Battle Creek, MI · On-site
$17 - $22.75/hr
Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process. We offer competitive wages based on experience and up to 3 ...
Prior Authorization Specialist
Battle Creek, MI · On-site
$17 - $22.75/hr
Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process. We offer competitive wages based on experience and up to 3 ...
Prior Authorization Nurse (LVN or RN) TEMP
Orange, CA · On-site
$37.50 - $40/hr
The role of the Case Manager, Prior Authorization Nurse is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and ...
Prior Authorization Nurse (LVN or RN) TEMP
Orange, CA · On-site
$37.50 - $40/hr
The role of the Case Manager, Prior Authorization Nurse is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and ...
Prior Authorization Specialist
Hamden, CT · On-site
$48K - $62K/yr
Track, follow up, and document all authorization statuses to ensure timely patient access to care. * Assist providers and nurses with prior authorization questions, refill coordination, and pharmacy ...
Prior Authorization Specialist
Hamden, CT · On-site
$48K - $62K/yr
Track, follow up, and document all authorization statuses to ensure timely patient access to care. * Assist providers and nurses with prior authorization questions, refill coordination, and pharmacy ...
Prior Authorization Nurse information
See salary details
$17.31 - $21.68
3% of jobs
$21.68 - $26.05
7% of jobs
$29.33 is the 25th percentile. Wages below this are outliers.
$26.05 - $30.42
20% of jobs
The median wage is $34.13 / hr.
$30.42 - $34.79
24% of jobs
$34.79 - $39.16
14% of jobs
$41.84 is the 75th percentile. Wages above this are outliers.
$39.16 - $43.53
11% of jobs
$43.53 - $47.90
7% of jobs
$47.90 - $52.27
5% of jobs
$52.27 - $56.64
3% of jobs
$56.64 - $61.01
3% of jobs
$61.01 - $65.38
2% of jobs
$17
$38
$65
How much do prior authorization nurse jobs pay per hour?
As of Jun 17, 2026, the average hourly pay for prior authorization nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.
What is the difference between Prior Authorization Nurse vs Utilization Review Nurse?
| Aspect | Prior Authorization Nurse | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, possibly certifications in case management | RN license, certifications in case management or utilization review |
| Work Environment | Healthcare facilities, insurance companies, or telehealth | Hospitals, insurance companies, or managed care organizations |
| Job Focus | Pre-authorization of specific procedures or treatments | Reviewing medical necessity and appropriateness of ongoing care |
While both roles involve nursing expertise and work within healthcare and insurance settings, the Prior Authorization Nurse primarily focuses on obtaining approval before procedures, whereas the Utilization Review Nurse evaluates ongoing care for medical necessity. Understanding these differences helps in choosing the right career path or job search focus.
Can nurses do prior authorizations?
Prior authorization nurses are trained healthcare professionals who review and process prior authorization requests for insurance coverage of medical services and medications. They evaluate medical necessity, ensure compliance with insurance policies, and often work closely with healthcare providers and insurance companies to facilitate approval. Certification in case management or related fields can enhance their effectiveness in this role.
What Does a Prior Authorization Nurse Do?
As a prior authorization nurse, you review requests for authorization for specific medications, treatments, or surgeries. Your duties include reviewing medical records and documents related to the application. You consider each prior authorization request and collect evidence and patient information to support your decision. You communicate with the insurance provider to obtain additional information if needed. Your responsibilities in this position also involve ensuring the authorization meets regulations and requirements and contractual obligations of all parties involved. Your job can also require coordinating with administrators and healthcare providers to gain necessary information and ensure that patients receive authorized care.
How to make 300,000 a year as a nurse?
To earn $300,000 annually as a Prior Authorization Nurse, professionals typically need extensive experience, advanced certifications, and specialization in high-demand areas such as oncology or cardiology. Working in management roles, consulting, or in high-paying healthcare organizations can also increase earning potential, often requiring strong clinical knowledge, efficiency, and negotiation skills.
What are Prior Authorization Nurses?
Prior Authorization Nurses are registered nurses who evaluate medical requests and determine if procedures, medications, or services meet clinical guidelines for insurance coverage. They work closely with healthcare providers, insurance companies, and patients to ensure that prior authorization requirements are met before treatments or medications are approved. Their role helps streamline care delivery, reduce unnecessary costs, and ensure patients receive appropriate, covered services in a timely manner.
How to make an extra $2000 a month as a nurse?
Prior Authorization Nurses can increase their income by taking on additional shifts, working overtime, or offering consulting services to healthcare providers. Developing specialized skills in insurance review and obtaining relevant certifications can also command higher pay or freelance opportunities, especially in flexible or remote roles.
What are the key skills and qualifications needed to thrive as a Prior Authorization Nurse, and why are they important?
To thrive as a Prior Authorization Nurse, you need a solid background in nursing, knowledge of insurance guidelines, and an active RN license. Familiarity with prior authorization software, electronic health records (EHRs), and payer-specific portals is typically required. Strong attention to detail, critical thinking, and effective communication help in collaborating with providers and navigating complex cases. These skills are essential to ensure accurate, timely authorization of medical services, which directly impacts patient care and healthcare reimbursement.
How to make 150,000 as a nurse?
A Prior Authorization Nurse can earn $150,000 by gaining extensive experience, obtaining relevant certifications, and working in high-paying settings such as specialty clinics or insurance companies. Advancing to senior or managerial roles, working overtime, or taking on consulting opportunities can also increase earning potential.
What are some common challenges faced by Prior Authorization Nurses in coordinating with insurance providers?
Prior Authorization Nurses often encounter challenges such as navigating varying requirements from different insurance providers, managing tight turnaround times for approvals, and ensuring that clinical documentation is thorough and accurate. Effective communication and attention to detail are essential, as missing or unclear information can delay authorizations. Building collaborative relationships with providers, physicians, and insurance representatives helps streamline the process and improves patient outcomes.
More about Prior Authorization Nurse jobs
What cities are hiring for Prior Authorization Nurse jobs? Cities with the most Prior Authorization Nurse job openings:
What are the most commonly searched types of Prior Authorization Nurse jobs? The most popular types of Prior Authorization Nurse jobs are:
Who are the top companies hiring for Prior Authorization Nurse jobs? The top employers for Prior Authorization Nurse jobs are:
What states have the most Prior Authorization Nurse jobs? States with the most job openings for Prior Authorization Nurse jobs include:
What job categories do people searching Prior Authorization Nurse jobs look for? The top searched job categories for Prior Authorization Nurse jobs are:
- Remote Preservice Review Nurse
- Registered Nurse Reviewer
- Prior Authorization Licensed Practical Nurse
- Remote Cigna Utilization Review Nurse
- Per Diem Chart Review Nurse Practitioner
- Utilization Management Nurse Reviewer
- Prior Authorization Review Nurse
- Internship Rn Utilization Review Nurse
- Utilization Review Nurse Lvn
- Remote Amazon Lpn
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Company Job Description/Day to Day Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute careÂ
Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.
Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.
Additional Information
Employment Type: Temporary Assignment (1-2 months)
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003