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Prior Authorization Rn Jobs in Rhode Island (NOW HIRING)

Maxim Health Systems

RN Pediatric Homecare

Chepachet, RI · On-site

$40 - $45/hr

One year prior Registered Nurse (RN) experience preferred. Maxim Benefits: Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health ...

New

Maxim Health Systems

Novice RN/LPN Homecare

Pawtucket, RI · On-site

$30 - $35/hr

One year prior Registered Nurse (RN) experience preferred. Maxim Benefits: Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health ...

New

DOCS Health

Registered Nurse

Providence, RI · On-site

Attention all Registered Nurses, we are calling you to partner with us as independent contractors ... Interview military personnel to determine current and prior medical concerns. * Identify any ...

DOCS Health

Registered Nurse

Providence, RI · On-site

Attention all Registered Nurses, we are calling you to partner with us as independent contractors ... Interview military personnel to determine current and prior medical concerns. * Identify any ...

DOCS Health

Registered Nurse

Providence, RI · On-site

Description Attention all Registered Nurses, we are calling you to partner with us as independent ... Interview military personnel to determine current and prior medical concerns. * Identify any ...

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Showing results 41-60

All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Rhode Island

Prior Authorization Rn information

See Rhode Island salary details

$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for prior authorization rn in Rhode Island is $41.37, according to ZipRecruiter salary data. Most workers in this role earn between $30.82 and $48.94 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.
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Rhode Island as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $86,050 per year, or $41.4 per hour.

RN (Open Position) Private Duty Nurses needed Cumberland RI

Maxim Healthcare

Cumberland, RI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Maxim Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 165 frontline employees who took The Breakroom Quiz

416th of 887 rated healthcare providers

Job description

CumberlandRI02864G-tube Pedi,M-F Evenings12p-7pRN- $40-$42


Maxim Healthcare Services is seeking a Registered Nurse (RN) to assume responsibility and accountability for the application of the nursing process and the delivery of patient care. The Registered Nurse (RN) demonstrates the ability to make clinical judgments in an effective and efficient manner under the direction of the Director of Clinical Services.

Responsibilities

  • Utilizes the nursing process to assess, plan, implement and evaluate patient care.
  • Assess signs and symptoms indicating physiologic and psychosocial changes in the patient’s condition.
  • Collects, analyzes, and interprets data and information from health care members and documents actual and/or potential nursing diagnoses.
  • Documents the patient’s plan of care using identified nursing diagnoses, expected patient outcomes, and selected nursing interventions.
  • Performs interventions according to identified priorities, plan of care, and the hospital policies and patient care outcome standard.
  • Revises the plan of care according to evaluation, changes in medical plan of care, and effective/ineffective nursing interventions.
  • Uses clinical judgment in evaluation activities to meet patient care needs of an assigned unit/floor including establishing priorities.
  • Other Registered Nurse (RN) duties as assigned.

Requirements

  • Current Registered Nurse (RN) License for the state in which the nurse practices.
  • Current Health Certificate (per facility Registered Nurse (RN) contract or state regulation).
  • Current PPD or Chest X-Ray.
  • Current BLS card.
  • One year prior Registered Nurse (RN) experience preferred.

Benefits

At Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:

  • Competitive pay & weekly paychecks
  • Health, dental, vision, and life insurance
  • 401(k) savings plan
  • Awards and recognition programs

About Maxim Healthcare Services

Maxim Healthcare Services has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.

Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

**CO Specific Benefits: Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical), Health Advocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Life and Accidental Death & Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, Transportation Benefits, CommonBond, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays

What Maxim Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Maxim Healthcare

Sourced by ZipRecruiter

At Maxim, our priority is providing exemplary care for our patients and their families. Our team of nurses, therapists, and home health aides help patients of all ages maintain their quality of life.

Industry

Health care and social assistance and recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Columbia, MD, US

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