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Prior Authorization Rn Jobs in Kentucky (NOW HIRING)

... prior authorizations . * Ensures clinical communications are managed, tasks are completed and ... Active, Unrestricted Registered Nurse Licensure in the state that you reside * BLS or CPR ...

... prior authorizations . * Ensures clinical communications are managed, tasks are completed and ... Active, Unrestricted Registered Nurse Licensure in the state that you reside * BLS or CPR ...

... prior authorizations . * Ensures clinical communications are managed, tasks are completed and ... Active, Unrestricted Registered Nurse Licensure in the state that you reside * BLS or CPR ...

Posted today

... prior authorizations . * Ensures clinical communications are managed, tasks are completed and ... Active, Unrestricted Registered Nurse Licensure in the state that you reside * BLS or CPR ...

... prior authorizations . * Ensures clinical communications are managed, tasks are completed and ... Active, Unrestricted Registered Nurse Licensure in the state that you reside * BLS or CPR ...

The Registered Nurse provides clinical support through patient triage, prior authorizations, prescription refill requests, care coordination, population health initiatives, and day-to-day clinical ...

New

Registered Nurse

Lexington, KY · On-site

$54K - $116K/yr

... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ... Active, Unrestricted Registered Nurse Licensure in the state that you reside * BLS or CPR ...

Medical Assistant or LPN

Lexington, KY · On-site

$18.25 - $23.50/hr

... prior authorizations, and coordinating tests and procedures. Upon successful completion of clinical ... Medical Assistant, MA, CMA, Certified Medical Assistant, Clinical, Office, Clinic, RMA, Registered ...

Medical Assistant or LPN

Lexington, KY · On-site

$18.25 - $23.50/hr

... prior authorizations, and coordinating tests and procedures. Upon successful completion of clinical ... Medical Assistant, MA, CMA, Certified Medical Assistant, Clinical, Office, Clinic, RMA, Registered ...

Obtains pre-authorization of medications as required. * Coordinates lab work and any specific ... Active/unrestricted RN licensure in Kentucky or state of location of the practice. * Must maintain ...

Obtains pre-authorization of medications as required. * Coordinates lab work and any specific ... Active/unrestricted RN licensure in Kentucky or state of location of the practice. * Must maintain ...

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Consistently checks eligibility for every resident and submits prior authorization when applicable. * Coordinate and prepare financial estimates, purchase orders and invoices for patients and nursing ...

Showing results 41-60

Prior Authorization Rn information

See Kentucky salary details

$6

$36

$62

How much do prior authorization rn jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for prior authorization rn in Kentucky is $36.69, according to ZipRecruiter salary data. Most workers in this role earn between $27.36 and $43.41 per hour, depending on experience, location, and employer.

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.

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 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 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 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 are popular job titles related to Prior Authorization Rn jobs in Kentucky? For Prior Authorization Rn jobs in Kentucky, the most frequently searched job titles are:
What cities in Kentucky are hiring for Prior Authorization Rn jobs? Cities in Kentucky with the most Prior Authorization Rn job openings:
Infographic showing various Prior Authorization Rn job openings in Kentucky as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, 1% Temporary, and 4% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $76,315 per year, or $36.7 per hour.

Registered Nurse

CVS Health

Lexington, KY • On-site

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago


CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,332 frontline employees who took The Breakroom Quiz

89th of 112 rated pharmacies


Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Company: Oak Street Health

Title: Center Nurse

Role Description

The Center Nurse is a clinical care team member operating within a Value-Based Care model, which prioritizes patient health outcomes and long-term wellness. In this model, the Center Nurse supports the health of patients by utilizing standards, guidelines and pathways for care delivery to prevent complications before they occur. Our Center Nurses drive quality care through clinical assessments, chronic condition management, and collaborating with the care team to reduce avoidable hospitalizations. You will foster an engaging and welcoming environment through effective team communication and delegation, empowering everyone on the team to deliver the best care to our patients.

Our Center Nurses report to the Practice Manager.

Core Responsibilities:

  • Support patient assessment and prioritization for both walk-in and telephonic triage to ensure patients receive the right level of care and avoid unnecessary hospital visits.

  • Execute protocol-driven chronic condition management .

  • Perform skilled nursing procedures including wound care and medication administration (including vaccines).

  • Provide comprehensive patient and caregiver education regarding chronic conditions and preventative care in person, over the phone, or in group settings.

  • Conduct medication reviews within nurse-led visits to ensure patient safety and adherence.

  • Conduct onsite testing (including point-of-care labs, EKGs, and specimen collection) and use patient data to identify and close gaps in preventative screenings , ensuring compliance with state scope of practice.

  • Review and act upon high-priority abnormal laboratory results in a timely manner to maintain patient safety and continuity of care.

  • Partner with providers and the interdisciplinary team to manage complex care plans and coordinate weekly transitions for patients moving from the hospital back to the clinic.

  • Utilize standardized protocols for medication management, prescription renewals and prior authorizations .

  • Ensures clinical communications are managed, tasks are completed and patient visit encounters are closed in a timely manner.

  • Delegates to medical assistants and phlebotomists as needed to support patient flow and efficiency.

  • Performs other related duties as assigned.

Clinical Responsibilities:

  • Supports the coordination, integration, communication, and implementation of nursing practice and standard operating procedures.

  • Identifies barriers to optimal care, e.g. physical, cognitive, language, literacy, socioeconomic, cultural, and or behavioral.

  • Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are.

  • Deliver an exceptional patient experience through service, responsiveness and respectful care.

  • Serve as a key clinical voice in daily care team meetings to align on patient priorities and clinic operations.

  • Serves as a support and resource for nursing, other clinical staff and providers.

  • Ensures clinical compliance with Patient Safety initiatives and reporting.

  • Provides emergency care in accordance with organizational procedure.

Professional Responsibilities:

  • Engages in self-evaluation and participates in activities to promote own professional growth and development.

  • Seeks, acquires and maintains current nursing knowledge and competence to fulfill responsibilities as a Center Nurse.

  • Maintains awareness of current patient centered, evidence-based practice and considers applicable research data to patient care delivery.

  • Fulfills obligation to identify and report professional misconduct appropriately.

What we’re looking for

Required Qualifications:

  • Active, Unrestricted Registered Nurse Licensure in the state that you reside

  • BLS or CPR Certification

  • Fluent written and spoken English language skills.

  • US work authorization

  • Electronic Medical Record (EMR) experience

  • Ability to maintain patient confidentiality and process information in a confidential manner

  • Ability to assess patients without face-to face interaction, strong communication and assessment skill

Strongly Preferred Qualifications:

  • Ability to collaborate and communicate with members of an interdisciplinary care team

  • Excellent computer skills with ability to read, interpret and analyze data from various computer systems

  • Effective problem solving and prioritization skills

Preferred Qualifications:

  • Previous experience in clinic setting

  • Ability to work independently

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $116,760.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 10/06/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.


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