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Prior Authorization Rn Jobs in Massachusetts (NOW HIRING)

Valley Health Systems

Registered Nurse

Holyoke, MA · On-site

$34.33 - $53.81/hr

... prior authorizations, prescription refills, and adherence to clinical protocols Qualifications ... Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR ...

Vinfen

Clinical Care Manager (RN)

Hyannis, MA · On-site

$90K/yr

The RN is supervised by the Care Team Leader and will learn about working on a community-based ... Obtain required Prior Authorization from Managed Care Plan (ACOs, MCOs) for relevant and necessary ...

Vinfen

Clinical Care Manager (RN)

Allston, MA · On-site

$90K/yr

The RN is supervised by the Care Team Leader and will learn about working on a community-based ... Obtain required Prior Authorization from Managed Care Plan (ACOs, MCOs) for relevant and necessary ...

FENWAY HEALTH

LPN

Boston, MA

$28.21 - $31.13/hr

Provides nursing support to RNs, LPNs and MAs * Places and Maintains IV Lines * Administers ... Works with MA and pharmacy to call in prescription refills or obtain prior authorizations * Assists ...

Exaways Corporation

Pharmacy Patient Liaison

Boston, MA · On-site

$19 - $23/hr

... prior authorization submission 2) Successful team members are self-motivated and excel in time ... staff (CNAs, MDs, RNs) 4) Capacity to work independently by managing workload and meeting ...

Fenway Health

LPN

Boston, MA · On-site

$28.21 - $31.13/hr

Provides nursing support to RNs, LPNs and MAs * Places and Maintains IV Lines * Administers ... Works with MA and pharmacy to call in prescription refills or obtain prior authorizations * Assists ...

Vinfen

Clinical Care Manager (RN)

Somerville, MA · On-site

$90K/yr

The RN is supervised by the Care Team Leader and will learn about working on a community-based ... Obtain required Prior Authorization from Managed Care Plan (ACOs, MCOs) for relevant and necessary ...

Fenway Health

LPN

Boston, MA · On-site

$28.21 - $31.13/hr

Provides nursing support to RNs, LPNs and MAs * Places and Maintains IV Lines * Administers ... Works with MA and pharmacy to call in prescription refills or obtain prior authorizations * Assists ...

Fenway Health

LPN, Part-Time

Boston, MA

$28 - $38/hr

Provides nursing support to RNs, LPNs and MAs * Places and Maintains IV Lines * Administers ... Works with MA and pharmacy to call in prescription refills or obtain prior authorizations * Assists ...

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Massachusetts

Prior Authorization Rn information

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$8

$46

$78

How much do prior authorization rn jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for prior authorization rn in Massachusetts is $46.14, according to ZipRecruiter salary data. Most workers in this role earn between $34.38 and $54.62 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

What are the most commonly searched types of Prior Authorization Rn jobs in Massachusetts?

The most popular types of Prior Authorization Rn jobs in Massachusetts are:

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For Prior Authorization Rn jobs in Massachusetts, the most frequently searched job titles are:

What job categories do people searching Prior Authorization Rn jobs in Massachusetts look for?

The top searched job categories for Prior Authorization Rn jobs in Massachusetts are:

What cities in Massachusetts are hiring for Prior Authorization Rn jobs?

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

Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Massachusetts as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $95,962 per year, or $46.1 per hour.

Registered Nurse

Valley Health Systems

Holyoke, MA • On-site

$34.33 - $53.81/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 24 days ago

Job description

$5,000 SIGN-ON BONUS FOR FULL-TIME RN
WITH AT LEAST TWO YEARS OF EXPERIENCE AS AN RN
Note: The compensation range noted above represents the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range.
Valley Health Systems, Inc., the parent company of Holyoke Medical Center, provides a broad range of physician services in offices conveniently located throughout Western Massachusetts. Holyoke Medical Center is an independent community hospital that has served the healthcare needs of the Pioneer Valley for over 125 years. We continue to grow and address the needs of our community through quality and patient-centered care.
Our Specialty Physician Practice is seeking an experienced Registered Nurse to deliver patient-centered nursing care and support the coordination of services across the care continuum, ensuring safe, efficient, and high-quality clinical outcomes.
The Office Nurse serves as a critical link between patients, MDs / Providers, and the care team across the continuum of surgical care. This role combines clinical expertise with care coordination, ensuring timely access, seamless navigation, and high-quality patient-centered care from initial consultation through post-operative follow-up. Key responsibilities include but are not limited to:
  • Perform comprehensive nursing assessments
  • Administer medications, injections, and wound care in accordance with clinical protocols
  • Provide direct clinical support during office visits, minor procedures, and follow-up care
  • Review diagnostic results (labs, imaging) and escalate findings appropriately to MDs/Providers.
  • Serve as the primary point of contact for patients throughout the surgical journey
  • Coordinate pre-operative requirements, including medical clearances, labs, imaging, and specialty consultations
  • Facilitate timely scheduling of OR procedures and Patient Navigation in collaboration with Manager, Surgical Schedulers and PAT Nurses.
  • Educate patients and families on surgical procedures, risks, preparation, and recovery expectations
  • Conduct post-operative follow-up, including symptom management, wound assessment, and complication screening
  • Triage post-operative calls and coordinate escalation when clinically indicated.
  • Deliver clear, compassionate, and culturally competent education aligned with AIDET principles
  • Collaborate with the Manager, front desk, surgery schedulers, and MDs and Providers to optimize patient flow and access.
  • Support referral management and ensure appropriate clinical prioritization
  • Assist in reducing OR Bookings delays, cancellations, and no-shows through proactive coordination with the Manager and Surgery Schedulers.
  • Maintain accurate, timely documentation within the EMR (e.g., Meditech Expanse)
  • Complete FMLA/Disability Paperwork
  • Ensure compliance with DNV's standards, regulatory, infection control, and safety standards
  • Assist in prior authorizations, prescription refills, and adherence to clinical protocols

Qualifications:
Education: Graduate of an accredited program for Registered Nurses
License/Certification: Current license as a Registered Nurse within the Commonwealth of Massachusetts; current CPR
Experience: Two years of experience in an outpatient physician's office, preferably in the specialty.
Our competitive salary package is adjusted to align with a candidate's relevant experience and skills. We also offer:
  • Low cost health insurance with no deductibles when using HMC services
  • Dental and vision insurance
  • Free disability and life insurance
  • 403(b) plan
  • Up to $8000 in degree/tuition reimbursement
  • In-House Pharmacy
  • Relaxation Room and Fitness Center
  • Other voluntary benefits, such as LegalShield, Pet Insurance
  • Free onsite parking

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