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Prior Authorization Rn Jobs in Minnesota (NOW HIRING)

Newport Healthcare

RN -PHP

Maplewood, MN · On-site

$38 - $51/hr

The PHP RN is responsible to assess, plan, implement, evaluate, and supervise nursing care of ... Obtains insurance pre-authorizations for medications and tracks prior authorizations in clinics.

Newport Healthcare

RN -PHP

Maplewood, MN

$38 - $51/hr

The PHP RN is responsible to assess, plan, implement, evaluate, and supervise nursing care of ... Obtains insurance pre-authorizations for medications and tracks prior authorizations in clinics.

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All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Minnesota

Prior Authorization Rn information

See Minnesota salary details

$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for prior authorization rn in Minnesota is $41.37, according to ZipRecruiter salary data. Most workers in this role earn between $30.87 and $48.99 per hour, depending on experience, location, and employer.

What do prior authorization nurses do?

Prior authorization nurses review medical documentation and communicate with healthcare providers and insurance companies to obtain approval for specific treatments, medications, or procedures. They ensure that requests meet insurance criteria, often using electronic health records and authorization systems, to facilitate timely patient care.

How to make 150,000 as a nurse?

A Prior Authorization RN 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 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.

How to make $300,000 as a nurse?

A Prior Authorization RN can increase earnings by gaining specialized certifications, working in high-paying healthcare settings, or taking on overtime and extra shifts. Developing expertise in insurance processes and healthcare regulations can also lead to higher-paying roles or consulting opportunities.

How to make an extra 2000 a month as a nurse?

A Prior Authorization RN can increase income by taking on overtime shifts, working in high-demand specialties, or obtaining certifications to qualify for higher-paying roles. Additionally, freelance consulting or remote review work can provide supplementary income outside regular hours.

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.
More about Prior Authorization Rn jobs
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Minnesota as of July 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% In-person job distribution, with an average salary of $86,059 per year, or $41.4 per hour.
Care Coordinator RN

Care Coordinator RN

Fairview Health Services

Minneapolis, MN • On-site

$85K - $121K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Fairview Health Services rating

7.7

Company rating: 7.7 out of 10

Based on 245 frontline employees who took The Breakroom Quiz

157th of 884 rated healthcare providers

Job description

Job Overview
Fairview is seeking a Care Coordinator RN to join the Surgical Specialties team at M Health Fairview Clinics & Surgery Center. This is a casual, hybrid position, with approximately 50% remote work available following successful completion of orientation and training.
This role offers variable day shifts, with start and end times based on department and patient care needs, generally falling between 7:00 a.m. and 6:00 p.m. As a casual position, scheduled hours will vary based on staffing and operational needs.
This opportunity provides excellent flexibility, with no weekends, no holidays, and no on-call requirements, making it an ideal role for an experienced RN seeking a balance of meaningful patient care, autonomy, and work-life flexibility.
This position focuses on an area of a specific medical specialty or chronic care condition (i.e. endoscopy, enterostomal therapy, mental health, total parenteral nutrition, bone marrow transplant). Serves as a resource and educator to patient, medical and hospital staff within the specialty. Coordinates care efforts for a safe, effective, efficient and patient centered transition along the health continuum. Provides pro-active disease management using evidence based practices. Acts as a liaison between patient/family, medical staff and others involved in treatment, promoting patient centered care based on jointly determined health care goals and priorities.
Responsibilities
  • Accesses, analyzes, plans and provides follow-up care.
  • Facilitates timely referrals and fosters positive relations with community providers.
  • Evaluates and documents status and follows patient progress through phone calls, test results and report preparation. Evaluates quality of nursing care via patient rounds.
  • Identifies problems that are specific to the clinical specialty.
  • Provides pro-active disease management using evidence based practices.
  • Serves as a liaison between patient/family, medical staff and others involved in treatment, promoting patient centered care based on jointly determined health care goals and priorities
  • Collaborates with appropriate staff to provide coordinated transition of care across the healthcare continuum.
  • Facilitates timely referrals and fosters positive relations with community providers.
  • Provides direct patient care in the area of specialty.
  • Establishes individual nursing care plans.
  • Provides education, counseling, medication management, and general health information to patients and patient representatives.
  • Triages patient concerns and responds to patient concerns between visits under provider direction, to reduce relapse or inpatient care.
  • Functions as a resource to patient care units, outpatient clinics and medical staff regarding the clinical specialty.
  • Identifies need and assists in writing and implementing policies and procedures.
  • Provides education services to patients and their families and other hospital staff regarding the clinical specialty. Develops content, resource materials and coordinates the educational plan.
  • Serves on task forces and committees related to the clinical specialty.
  • Keeps up to date on technological advances and new pharmaceutical products.
  • Consults with other areas regarding specialty.
  • Assists with research projects which may include collection data, data analysis and evaluation. May identify research projects.
  • Manages database to track patient outcomes and other specific categories as directed by physician.
  • Promotes program and assists with marketing efforts. Oversees or manages prior authorization process and results verification process to ensure positive image.
  • Provide effective educational material.
  • Serves as a community liaison.
  • Performs other duties including Performance Goals developed by manager and employee and reported in the employee's Performance Review as part of UMPhysicians' Performance Management tools
  • Develops and maintains critical competencies listed in this job description and the competencies drop down list in the employee's online performance management tool.

Required Qualifications
  • 3 years specialty experience doing care coordination or
  • 5 years licensed RN with five years of clinical experience and ability to learn new specialty area
  • MN Registered Nurse (RN) License
  • Basic Life Support

Preferred Qualifications
  • Licensed RN with four year Baccalaureate Degree (BSN)
  • 2 years RN experience in the specialty area or previous care coordination experience
  • Specialized knowledge of the specialty and conditions of served population
  • EPIC

Benefit Overview
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link foradditional information: https://www.fairview.org/careers/benefits/noncontract
Compensation Disclaimer
The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
EEO Statement
EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

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About Fairview Health Services

Sourced by ZipRecruiter

Fairview Health Services is an industry-leading, award-winning nonprofit that offers an entire network of healthcare services. Fairview is one part of M Health Fairview, a partnership between the University of Minnesota, M Physicians and Fairview Health Services. Together, we combine the University's deep history of clinical innovation and training with Fairview's extensive roots in community medicine. Our care portfolio includes community hospitals, academic hospitals, primary and specialty care clinics, senior facilities, facilitated living centers, rehabilitation centers, home health care services, counseling, pharmacies and benefit management services.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Minneapolis, MN, US

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