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Prior Authorization Rn Jobs in Rhode Island (NOW HIRING)

Job Title: RN Float (Med/Surg Telemetry & PCU) Facility: Landmark Medical Center Address: 115 Cass ... Current ACLS and BLS certifications (must already be active prior to start; compliance-only ...

Prior PDN, ER or critical care experience is preferred but not required. Training with the client and specific care needs will be provided. The Registered Nurse is accountable for ensuring the ...

Verifies patient's identity prior to surgical procedure. * Performs nursing duties according to ... Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or ...

Registered Nurse OR

Providence, RI · On-site

$35.56 - $59.99/hr

Verifies patient's identity prior to surgical procedure. * Performs nursing duties according to ... Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or ...

Registered Nurse OR

Providence, RI · On-site

$35.56 - $59.99/hr

Verifies patient's identity prior to surgical procedure. Performs nursing duties according to ... MINIMUM QUALIFICATIONS Licensure as Registered Nurse in the State of Rhode Island by the Rhode ...

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Prior Authorization Rn information

See Rhode Island salary details

$7

$41

$70

How much do prior authorization rn jobs pay per hour?

As of Jul 23, 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 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.
What are popular job titles related to Prior Authorization Rn jobs in Rhode Island? For Prior Authorization Rn jobs in Rhode Island, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Rn jobs in Rhode Island look for? The top searched job categories for Prior Authorization Rn jobs in Rhode Island are:
Infographic showing various Prior Authorization Rn job openings in Rhode Island as of July 2026, with employment types broken down into 72% Full Time, 22% Part Time, and 6% Contract. Highlights an 100% In-person job distribution, with an average salary of $86,050 per year, or $41.4 per hour.

$38K/yr

Other

Posted 2 days ago


Job description

This is an OPEN CONTINUOUS ANNOUNCEMENT. The initial cut-off date for referral of eligible applications is Friday, May 29, 2026 and applicants will be referred on an 'as needed' basis thereafter. Announcement will remain open through 08/24/2026 but may be extended or closed after the initial cut-off date if needed prior to the initial closing date.
Note: Vacancies may not currently exist at all locations, but may later prior to the closing date. Applicants will be notified at time of referral.Qualifications:VA Health Professional Trainees (HPT) pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. A HPT is an individual appointed to temporary positions in one or more VHA medical facilities performing clinical or research training experiences to satisfy program or degree requirements or receiving VA Health Professional Scholarship Program. HPTs can be either VA-paid or Without Compensation (WOC).
Basic Requirements:
  • English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).
  • Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)
NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.
Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12969189.Grade/LevelScopeEducationNurse I, Level IDelivers fundamental, knowledge-based care to assigned clients while developing technical competencies.An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.Nurse I, Level IIDemonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required.Nurse I, Level IIIDemonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.Nurse IIDemonstrates leadership in delivering and improving holistic care through collaborative strategies with others.A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.Nurse IIIExecutes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III.*Note: Foreign education programs/degrees are not creditable as related degrees.
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: The physical requirements of this position are concerned with the mental and physical ability of the applicant to satisfactorily perform the duties of the proposed assignment and may include requisite laboratory and other screening as required by Federal regulatory agencies.Education:Employment Type: OTHER