BH Nurse - RN
Madison, WI · On-site
... medication prior authorizations, referrals, labs or other orders; and coordinating with other healthcare providers. The SUD RN responds to urgent requests and provides screening and triage ...
BH Nurse - RN
Madison, WI · On-site
... medication prior authorizations, referrals, labs or other orders; and coordinating with other healthcare providers. The SUD RN responds to urgent requests and provides screening and triage ...
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
RN - Pain Clinic
Fort Atkinson, WI · On-site
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
RN - Pain Clinic
Fort Atkinson, WI · On-site
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
Clinic RN - Family Med (FT)
Edgerton, WI · On-site
... Registered Nurse to join our family medicine clinic team. This position is ideal for a nurse who ... orders, referrals, prior authorizations, and follow-up coordination * Maintain accurate ...
Clinic RN - Family Med (FT)
Edgerton, WI · On-site
... Registered Nurse to join our family medicine clinic team. This position is ideal for a nurse who ... orders, referrals, prior authorizations, and follow-up coordination * Maintain accurate ...
Computer skills required, prior experience with electronic medical record systems preferred ... authorization.
Computer skills required, prior experience with electronic medical record systems preferred ... authorization.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
Computer skills required, prior experience with electronic medical record systems preferred ... authorization.
Computer skills required, prior experience with electronic medical record systems preferred ... authorization.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... confirm work authorization. Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
The RN performs as a professional nurse in patient care, triage, and education, working under the ... prior authorizations for medical care and treatment. * Administers medication by all routes ...
Coordinate with Prior Authorization Nurse the patients need for continuing services and providing ... Current WI RN license * 1-2 years of Med/Surg or Home Care experience * Current/Valid WI Drivers ...
Coordinate with Prior Authorization Nurse the patients need for continuing services and providing ... Current WI RN license * 1-2 years of Med/Surg or Home Care experience * Current/Valid WI Drivers ...
... authorization. Student or Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Student or Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program. One year of RN experience in an ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Graduate of a baccalaureate nursing program. One year of RN experience in an ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Student or Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
... authorization. Student or Graduate of a nursing program. All entry-level associate degree ... Computer skills required, prior experience with electronic medical record systems preferred.
Coordinate with Prior Authorization Nurse the patients need for continuing services and providing ... Current WI RN license * 1-2 years of Med/Surg or Home Care experience * Current/Valid WI Drivers ...
Coordinate with Prior Authorization Nurse the patients need for continuing services and providing ... Current WI RN license * 1-2 years of Med/Surg or Home Care experience * Current/Valid WI Drivers ...
Registered Nurse - Primary Care
Milwaukee, WI · On-site +1
$74.19K - $129.27K/yr
Not authorized Permanent Change of Station (PCS) : Not authorized Requirements Help Conditions of ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Registered Nurse - Primary Care
Milwaukee, WI · On-site +1
$74.19K - $129.27K/yr
Not authorized Permanent Change of Station (PCS) : Not authorized Requirements Help Conditions of ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
Prior Authorization Rn information
See Wisconsin salary details
$7.52 - $13.46
0% of jobs
$13.46 - $19.39
0% of jobs
$19.39 - $25.32
4% of jobs
$25.32 - $31.26
18% of jobs
$32.04 is the 25th percentile. Wages below this are outliers.
$31.26 - $37.19
20% of jobs
The median wage is $39.63 / hr.
$37.19 - $43.12
18% of jobs
$48.46 is the 75th percentile. Wages above this are outliers.
$43.12 - $49.06
16% of jobs
$49.06 - $54.99
10% of jobs
$54.99 - $60.92
6% of jobs
$60.92 - $66.86
4% of jobs
$66.86 - $72.79
3% of jobs
$7
$42
$72
How much do prior authorization rn jobs pay per hour?
As of May 29, 2026, the average hourly pay for prior authorization rn in Wisconsin is $42.64, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $50.48 per hour, depending on experience, location, and employer.
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 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 is the difference between Prior Authorization Rn vs Medical Coder?
| Aspect | Prior Authorization Rn | Medical Coder |
|---|---|---|
| Credentials | RN license, possibly certifications in case management or utilization review | Certification in coding (CPC, CCS), no RN license required |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Medical offices, hospitals, insurance companies |
| Primary Responsibilities | Reviewing and obtaining prior authorizations for treatments and procedures | Translating 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
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What are popular job titles related to Prior Authorization Rn jobs in Wisconsin? For Prior Authorization Rn jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Rn jobs in Wisconsin look for? The top searched job categories for Prior Authorization Rn jobs in Wisconsin are:
What cities in Wisconsin are hiring for Prior Authorization Rn jobs? Cities in Wisconsin with the most Prior Authorization Rn job openings:
Full-time
Posted 25 days ago
Job description
Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER
.8 FTE / 32 Hours per week
The Behavioral Health Substance Use Disorder Registered Nurse (SUD RN) works collaboratively with a multidisciplinary team of addiction medicine physicians and advanced practice providers, certified substance abuse counselors and other staff to coordinate, support and deliver evidence-based, high-quality substance use disorder treatment. The SUD RN supports substance use disorder practitioners and their patients by managing communication between provider and patient; providing information and education regarding medication dosing, side effects, and interactions; assisting with prescription refills; performing brief triage and safety assessments; completing medication prior authorizations, referrals, labs or other orders; and coordinating with other healthcare providers. The SUD RN responds to urgent requests and provides screening and triage assessments as needed. The SUD RN works under the general supervision of the Director for Behavioral Health, with additional guidance and direction from the Medical Director - Substance Use Disorder. Substance Use Disorder physicians or advanced practice providers may delegate activities to the SUD RN that are within the RN scope of practice.
The SUD RN may provide cross coverage to behavioral health or primary care departments dependent on staffing and patient care needs.
The incumbent knows and abides by all Group Health Cooperative of South Central Wisconsin (GHC-SCW) organizational and departmental policies, sets personal standards and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner.The incumbent understands our Mission, Vision, and Common Values (stated below) and is committed to promote these values in behavior and attitude.
JOB SPECIFIC MINIMUM QUALIFICATIONS
Our Mission Statement: We partner with members and the communities we serve to maximize health and well-being.
Our Vision: As a local, not-for-profit, member-owned Cooperative, we are the most trusted resource for lifelong health and well-being in the communities we serve.
Our Values
We believe:
Healthcare is a human right.
In treating all people with dignity and respect.
There is strength in diversity.
Equity celebrates our humanity.
We are better together.
Group Health Cooperative of South Central Wisconsin is proud to be an equal opportunity employer. GHC-SCW considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
.8 FTE / 32 Hours per week
The Behavioral Health Substance Use Disorder Registered Nurse (SUD RN) works collaboratively with a multidisciplinary team of addiction medicine physicians and advanced practice providers, certified substance abuse counselors and other staff to coordinate, support and deliver evidence-based, high-quality substance use disorder treatment. The SUD RN supports substance use disorder practitioners and their patients by managing communication between provider and patient; providing information and education regarding medication dosing, side effects, and interactions; assisting with prescription refills; performing brief triage and safety assessments; completing medication prior authorizations, referrals, labs or other orders; and coordinating with other healthcare providers. The SUD RN responds to urgent requests and provides screening and triage assessments as needed. The SUD RN works under the general supervision of the Director for Behavioral Health, with additional guidance and direction from the Medical Director - Substance Use Disorder. Substance Use Disorder physicians or advanced practice providers may delegate activities to the SUD RN that are within the RN scope of practice.
The SUD RN may provide cross coverage to behavioral health or primary care departments dependent on staffing and patient care needs.
The incumbent knows and abides by all Group Health Cooperative of South Central Wisconsin (GHC-SCW) organizational and departmental policies, sets personal standards and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner.The incumbent understands our Mission, Vision, and Common Values (stated below) and is committed to promote these values in behavior and attitude.
JOB SPECIFIC MINIMUM QUALIFICATIONS
- Current licensure as a registered nurse (RN) is required. Must be licensed in the State of Wisconsin OR hold a multistate license in a state in the licensure compact (eNLC).
- Bachelor's degree in Nursing from an accredited college or university is preferred but not required.
- Two years of professional nursing experience is required. Experience working in substance use disorder setting is preferred. Experience in crisis intervention is preferred. A strong interest in working with people with substance use disorders is required.
- Possession of a valid Wisconsin driver license; and ability to travel to various work sites is required. Employee is expected to provide personal transportation.
- Possession of or eligibility for a valid Healthcare Provider CPR/AED certificate is required. Employee must obtain certification within four (4) months of employment.
- Knowledge of scientific nursing principles, methods and techniques in substance use disorders, behavioral health, and/or primary care setting as a basis for quality decision-making ability. Current knowledge of and maintenance of nursing trends, techniques and certifications.
- Participation in pertinent continuing education courses.
- Knowledge related to medications for substance use disorders and their management is strongly preferred.
- Demonstrated ability to work productively both independently as well as on teams with prescribers, therapists/counselors, other health care providers, and community agencies.
- Excellent problem-solving and analytical skills.
- Ability to educate patients and/or families as to the nature of substance use disorder issues and to provide support and intervention as well as instruction on proper care, treatments and follow-up.
- Ability to perform (within 6 months of hire) a variety of clinical skills which may include but are not limited to crisis risk assessment, crisis intervention strategies, monitoring of medications for substance use disorders, performing initial history of substance use, and giving injections.
- Ability and willingness to provide coordination of services in addition to providing direct services.
- Excellent interpersonal skills including verbal communication and listening skills, both in-person and on the phone.
- Ability to recognize and identify symptoms and problems related to substance use disorder, particularly intoxication or withdrawal. Strong nursing assessment skills.
- Ability to be calm, resourceful and flexible in emergency situations.
- Ability to prioritize changing patient conditions.
- Knowledge of interviewing practices and techniques used to gather information.
- Ability to work some evening hours is required.
- Ability to maintain quality, safety and /or infection control standards.
- Excellent customer service skills, strong interpersonal skills and the ability to be culturally competent and work with a diverse patient population.
- Knowledge of and/or ability to learn and use computer based applications such as MS Office, electronic medical record (EMR) systems and scheduling applications. Experience with EpicCare EMR is desirable. Must type a minimum of 30 WPM with minimal errors
- Knowledge of medical records, appropriate documentation, patient confidentiality and HIPAA.
- Basic understanding or ability to learn about reimbursement/insurance practices for medical care.
- Ability to maintain good working relationships with patients and staff.
- Good organizational skills in the delivery of clinical care.
- Ability to maintain a calm, professional demeanor always.
- Ability to climb, stoop, kneel and crouch. Ability to bend, reach, lift, pull, push and/or carry up to 10 pounds regularly and up to 50 pounds occasionally. Ability to talk (speak clearly), hear (conversation), see (corrected vision for near and far sight, color vision, and depth perception) on a frequent basis. Ability to stand and sit for prolonged periods of time.
Our Mission Statement: We partner with members and the communities we serve to maximize health and well-being.
Our Vision: As a local, not-for-profit, member-owned Cooperative, we are the most trusted resource for lifelong health and well-being in the communities we serve.
Our Values
- We are a not-for-profit Cooperative
- We are member-centered
- We are equitable and inclusive
- We are quality-driven
- We are innovative
- We are community involved
We believe:
Healthcare is a human right.
In treating all people with dignity and respect.
There is strength in diversity.
Equity celebrates our humanity.
We are better together.
Group Health Cooperative of South Central Wisconsin is proud to be an equal opportunity employer. GHC-SCW considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.