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Prior Authorization Rn Jobs in Florida (NOW HIRING)

Ackerman Cancer Center

Oncology Nurse

Jacksonville, FL · On-site

Obtaining prior authorization for specialty medications ​ Requirements * Registered Nurse (RN) experience in a clinical setting * Bachelor of Science in Nursing (BSN) * Current Florida Registered ...

IVX Health

Infusion Registered Nurse (RN)

Venice, FL · On-site

Support Operations and Training - Assist in inventory management, prior authorizations, and ... Active and Unrestricted Registered Nurse (RN) license * Life Support Certifications - BLS ...

CVCFL

Registered Nurse

Orlando, FL · On-site

Description: Registered Nurse (RN) - Cardiology Full Time | Non-Exempt | Orlando, FL The ... Coordinate referrals, prior authorizations, specialty testing, and follow-up appointments.

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How much do prior authorization rn jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for prior authorization rn in Florida is $31.57, according to ZipRecruiter salary data. Most workers in this role earn between $23.51 and $37.36 per hour, depending on experience, location, and employer.

What is a Prior Authorization RN?

A Prior Authorization RN is a registered nurse who specializes in reviewing and processing prior authorization requests for medical procedures, medications, or treatments. They evaluate clinical documentation to determine if requests meet insurance or regulatory criteria and often serve as a liaison between healthcare providers, patients, and insurance companies. Their role helps ensure that care is medically necessary and covered by the patient's health plan, streamlining access to important healthcare services while controlling costs.

What does a Prior Authorization RN do?

A prior authorization RN is a registered nurse who assesses applications for specific treatments, medical procedures, and medications. In this job, you review each request for medical coverage and determine the necessity or potential benefits of the treatment or medicine. You assess patient information and other factors to decide whether or not to authorize coverage. Your duties as a prior authorization RN also include reviewing denials of benefits and seeking additional information that could alter the initial decision. You document your findings for each case and present the evidence along with your decision. It is your job to review the case for each patient thoroughly while following all government regulations and healthcare provider policies.

What are the key skills and qualifications needed to thrive as a Prior Authorization RN, and why are they important?

To thrive as a Prior Authorization RN, you need a current RN license, strong clinical assessment skills, and a solid understanding of insurance guidelines and medical necessity criteria. Familiarity with utilization management software, electronic health records (EHRs), and payer-specific authorization systems is essential. Exceptional attention to detail, critical thinking, and effective communication help you advocate for patients and collaborate with healthcare providers and insurers. These skills ensure the efficient processing of authorizations, reduce delays in care, and support patients in receiving appropriate treatments.

What are some common challenges faced by Prior Authorization RNs, and how can they be addressed?

Prior Authorization RNs often navigate complex insurance guidelines and manage high volumes of requests, which can be challenging due to frequent policy updates and tight timelines. Staying organized, maintaining up-to-date knowledge of payer requirements, and leveraging electronic health record (EHR) systems can help streamline the process. Collaboration with providers and insurance representatives, as well as ongoing training, are essential for efficiently resolving issues and ensuring timely patient care.

What is the difference between Prior Authorization Rn vs Medical Coder?

AspectPrior Authorization RnMedical Coder
CredentialsRN license, possibly certifications in case management or utilization reviewCertification in coding (CPC, CCS), no RN license required
Work EnvironmentHospitals, insurance companies, healthcare facilitiesMedical offices, hospitals, insurance companies
Primary ResponsibilitiesReviewing and obtaining prior authorizations for treatments and proceduresTranslating medical records into coded data for billing and documentation

While both roles are integral to healthcare administration, the Prior Authorization RN focuses on obtaining approvals for patient care, requiring nursing credentials and clinical knowledge. In contrast, Medical Coders specialize in coding medical records for billing, emphasizing coding certifications. Understanding these differences helps healthcare professionals and job seekers identify the right career path or job opportunity.

More about Prior Authorization Rn jobs

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Cities in Florida with the most Prior Authorization Rn job openings:

Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Florida as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 88% Physical, 1% Hybrid, and 11% Remote job distribution, with an average salary of $65,663 per year, or $31.6 per hour.

RN Clinical Manager - Home Health

Saint Petersburg, FL • On-site

New Day Executive Search
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Other

Posted 9 days ago

Job description

RN Clinical Manager

We are seeking an experienced RN Clinical Manager to lead clinical operations for a growing home health organization in the St. Petersburg/Sarasota, Florida area. This is an opportunity for a strong home health leader who enjoys developing clinicians, improving quality, solving operational challenges, and making sure every episode of care is clinically sound and compliant.

Benefits and Compensation

Full-time, exempt leadership position. On-site professional office environment. Opportunity to play a meaningful role in clinical quality and organizational growth. Direct involvement in operational and financial performance. Leadership opportunity with influence over clinical processes, staff development, and patient outcomes. Exposure to multiple home-based service lines and payer types. Apple/Mac-based work environment. Professional growth opportunities as the organization expands. Compensation and additional benefit details to be discussed during the recruiting process.

Requirements & Qualifications

Active RN license; Florida licensure or eligibility required. Strong home health clinical leadership experience. Advanced working knowledge of OASIS, Medicare, Medicaid, Plans of Care/485s, and home health documentation. Knowledge of state and federal home health regulations. Experience with QA/PI, audits, clinical compliance, and documentation review. Experience supervising, coaching, and performance-managing clinical staff. Strong written, verbal, organizational, and technology skills.

Must Haves

Triage new referrals, determine appropriate disciplines, and ensure care plans and clinical goals are properly established. Track patient episodes through audits, case conferences, reassessments, and changes in clinical status. Review clinical documentation and care notes for accuracy, timeliness, continuity, and OASIS compliance. Remove documentation barriers and hold clinicians accountable for completing required notes and orders. Conduct field coaching and ride-alongs for onboarding, remediation, competency, and quality improvement. Coordinate physician orders and ensure changes are communicated and implemented. Oversee insurance eligibility verification and prior authorization processes that affect continuity of care. Handle clinician questions and complex patient-care issues during operating hours. Partner with leadership and finance around branch revenue, budgets, staffing efficiency, and operational performance.

Preferred Background & Skills

Previous Clinical Manager, Patient Care Manager, Director of Nursing, Clinical Supervisor, or Director of Clinical Services experience within home health. Joint Commission experience. Experience managing Nursing and Therapy services. Medicare-certified home health background. Experience with utilization review and outcomes tracking. Prior involvement with surveys, audits, corrective action plans, or accreditation. Experience supporting telehealth or patient portal adoption. Comfortable operating in a growing organization where leaders are expected to identify and solve problems rather than simply maintain existing processes.

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