Prior Authorization Rn Jobs in Wisconsin (NOW HIRING)

Date Prepared: August 2026 Department: Medical EEO Category: Professionals Exempt Reports to: Assistant Medical Director.

Provide professional nursing care for clinic patients of all ages according to established Nursing standards of care and practices. Assists medical team and providers as needed. Works on special projects, work plans, grant work, prior authorization work, and/or specializes in other patient care areas including community outreach, prompt care, prenatal, women’s health, minor surgery, general medical and behavioral health care. Participates as an active, professional member of various committees.

• Performs general nursing care to patients of all ages in accordance with Nursing standards of care.
• Collects and documents in the EPIC patient chart: all patient data and assessment results including vital signs, patient medical history including current chief complaints, allergies, social determinants, surgeries, medications, screenings and other information as needed.
• Administers and dispenses prescribed medications, immunizations and treatments in accordance with nursing standards of practice.
• Prepares equipment and assists provider before, during and after treatments, examination, and with testing of patients according to policies and procedures.
• Observes, records, and reports patient's condition and reaction to drugs and treatments to providers.
• Rooms and prepares patient for examinations and procedures.
• Collects patient assessment data for in-person or telephone triage calls and reports the findings/information to providers if necessary for how to proceed with patient or documents in telephone encounter with how the triage was resolved i.e., with medication, PCP appt or ER referral.
• Screens patients for appropriate information.
• Arranges for patient testing, diagnostics, ER referrals and referrals to specialists as ordered.
• Performs EKG's, PFT's and simple lab tests as ordered.
• Performs venipuncture to collect blood specimens when assistance is needed to backup Labcorp.
• Maintains patient's charts and information in accordance with HIPAA Policy.
• Instructs and educates patient and family regarding medications and treatment instructions.
• Maintains and reviews patient records, charts and other pertinent information in EPIC.
• Contact patients with test results according to Provider specifications.
• Attends required meetings and actively participates in committees as requested.
• Assists in-service training of staff and orientation of new staff.
• Participates in professional development activities and maintains professional affiliations.
• Maintains patient confidentiality according to policy and HIPAA regulations.
• Performs related work as required.
• Handles prescription refill requests in EPIC in-basket per EPIC or phone call to pharmacy as needed.
• Handles prior authorization and other paperwork within 24-48 hours.
• Participates in all safety programs which may include assignment to an emergency response team.
• Actively participates and is accountable for duties assigned that support the Mission and Values of being certified as a Patient Centered Medical Home (PCMH).
• Provides assistance to the other RN's or covers for them as needed.
• Provides Infectious Disease Training to staff members and or patient education as needed.
• Uses proper PPE with infectious disease patients and whenever needed.
• Follows all CHS policies, procedures, regulatory and legal requirements.
• Completes annual and subsequent required trainings on time.
• Assists providers with complex medical patients per telephone, provide care coordination or make referrals to care oordinators.
• Take Labcorp calls regarding critical lab values, discuss with providers and relay information to the patient per providers instructions.
• Take calls from Public Health Department or State Agencies gathering patient information regarding treatment of STDs for county/state reporting/collection of data.
• Make calls to other medical facilities gathering data (or reporting) regarding patient's labs results, imaging, diagnostic procedures or diagnosis of illness.
• Assists provider with joint injections, dressing changes, suture or staple removal, placing sutures, sling or splint placement, warts or skin tag removal, GYN procedures, toenail removal or other procedures as needed.

• Ability and determination to efficiently carry out Community Health System, Inc. mission statement.
• Work as part of a team with clinic staff in a collegial and collaborative relationship in which each understands and accepts the contributions and limitations of the other.
• Working knowledge of the sociocultural factors associated with the community’s use of social and health care services necessary.
• Ability to relate well to residents of low-income, multi-cultural neighborhoods, recognizing their right to participate in health care planning and decision-making.
• Ability to understand patient attitudes and needs, develop and orient program goals and concepts accordingly, and to work effectively toward accomplishment of these goals with all staff members.
• Ability to establish and maintain effective working relationships with co-workers, officials, the public, patients, other private and public health organizational representatives.
• Ability to work under pressure and high stress, maintain personal composure, evaluate situations and act/react appropriately and use tact in dealing with visitors, patients and difficult situations.
• Knowledge of organizational policy regulations and procedures to administer patient care.
• Knowledge of medical equipment and instruments to administer patient care.
• Knowledge of common safety hazards and precautions to establish a safe work environment.
• Skill in applying and modifying the principles, methods and techniques of professional nursing to provide ongoing patient care.
• Skill in preparing and maintaining records, writing reports and responding to correspondence.
• Skill in developing and maintaining department quality assurance.
• Skill in maintaining quality control standards.
• Focuses on solving conflict and creating appropriate solutions. Remains open to others’ ideas and tries new things.
• Ability to read and interpret written information.
• Follows instructions and responds to management direction.
• Completes tasks on time or notified appropriate person with an alternate plan.
• Ability to communicate clearly.
• Demonstration of evidence of continuing education (i.e., records of CEU's, attendance at workshops) is required.
• Ability to read and respond to emails in a timely fashion.
• Ability to identify and maintain confidential/HIPPA information.

Graduate of an accredited school of nursing required. Maintains license as a Registered Nurse or Licensed Practical in the State of Wisconsin. Bi-annual BLS Certification required.

1-2 years of professional nursing experience in a clinic setting is preferred.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently exposed to communicable diseases, toxic substances, medicinal preparations and other conditions common to a clinic environment.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is frequently exposed to significant work pace/pressure. The noise level in the work environment is usually moderate.

The RN reports to the Assistant Medical Director.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job class. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

Community Health Systems, Inc. is an equal opportunity employer.