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Prior Authorization Rn Jobs in Elk Grove, CA (NOW HIRING)

Advanced Home Health Inc.

Registered Nurse

Roseville, CA · On-site

$105K - $120K/yr

Registered Nurse (RN) Reports to: Clinical Manager/Clinical Director Position Summary: The ... Identifies discharge planning needs as part of the care plan development and implements prior to ...

Excelin Health

Registered Nurse

Roseville, CA · On-site

Registered Nurse (RN) Reports to: Clinical Manager/Clinical Director Position Summary: The ... Identifies discharge planning needs as part of the care plan development and implements prior to ...

Cranial Technologies

Registered Nurse

Sacramento, CA

$95K - $105K/yr

Licensed RN * Prior pediatric experience required * 500 hours of basic orthotic fitting experience ... Clinic Address: 2825 J St., Ste. 325 Sacramento, CA 95816 Applicants must be authorized to work for ...

Cranial Technologies

Registered Nurse

Sacramento, CA · On-site

$95K - $105K/yr

Licensed RN * Prior pediatric experience required * 500 hours of basic orthotic fitting experience ... Clinic Address: 2825 J St., Ste. 325 Sacramento, CA 95816 Applicants must be authorized to work for ...

Cranial Technologies

Registered Nurse

Sacramento, CA

$95K - $105K/yr

Licensed RN * Prior pediatric experience required * 500 hours of basic orthotic fitting experience ... Clinic Address: 2825 J St., Ste. 325 Sacramento, CA 95816 Applicants must be authorized to work for ...

UHS

Per Diem Registered Nurse (RN)

Sacramento, CA

The Registered Nurse is a professional who prescribes, coordinates, and evaluates patient care ... employment, and prior to assisting in a restraining process. Must demonstrate medication ...

North Pointe Care Center

Registered Nurse

Sacramento, CA · On-site

... authorized government agencies as requested by the Administrator or Director of Nursing Services ... prior to performing such tasks. • Ensure that an adequate supply of personal protective equipment ...

PACS

Registered Nurse

Sacramento, CA · On-site

... authorized government agencies as requested by the Administrator or Director of Nursing Services ... prior to performing such tasks. • Ensure that an adequate supply of personal protective equipment ...

Talent Software Services

Nurse RN 5

Roseville, CA · On-site

Prior work history of post service, prior auth, concurrent review. Preferential interview ... Requirements: * RN/LVN licensed in California Required Testing: The specific required testing is ...

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Showing results 21-40

All JobsPrior Authorization Rn JobsPrior Authorization Rn Jobs in Elk Grove, CA

Prior Authorization Rn information

See Elk Grove, CA salary details

$7

$44

$75

How much do prior authorization rn jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for prior authorization rn in Elk Grove, CA is $44.41, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $52.55 per hour, depending on experience, location, and employer.

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 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 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.

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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Elk Grove, CA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 1% Temporary, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $92,372 per year, or $44.4 per hour.

Licensed Vocational Nurse (LVN) in Roseville

Care Central Professionals LLC

Roseville, CA

$28.75 - $38.75/hr

Full-time

Re-posted 6 hours ago

Job description

JOB SUMMARY:

A Licensed Vocational Nurse provides practical nursing skills within the scope of nursing practice standards in collaboration with RN case managers/supervisors, teaches and educates patients and their families according to the established professional plan of care. Licensed Practical nursing is performed under the supervision of the assigned RN’s, Administrator, and Director of Patient Care Services.

QUALIFICATIONS :

Graduate of an approved LVN nursing school. 

Currently, licensed “in good standing” in CA. 

A minimum of one (1) year of experience as a licensed Vocational Nurse, preferably in a home care setting. 

Must have a criminal background check and current CPR certification.

RESPONSIBILITIES/ESSENTIAL FUNCTIONS  :

Maintains the nursing frequency established by the supervising RN. 

Prepares equipment & materials for treatments observing aseptic techniques as required. 

Reporting to the RN. 

Follows the plan of care established by the supervising RN. 

Performs home safety check and environmental check of the patient’s home environment on all visits. Reports any unsafe or potentially unsafe condition to the supervising RN. 

Performs nursing visit and documents accordingly.  

Reviews and follows the supervising RN’s plan of care, communicating frequently with the supervising RN on any suggested changes necessary. 

Collaborates with the supervising RN on a weekly (or more frequent basis) to benchmark toward the established outcome goals. 

Reviews the patient’s ADL and iADL abilities. 

Teaching of patient & family self-care techniques. 

Communicates any suggested changes to the supervising RN. 

Reinforces the HHA plan of care when HHA services are ordered.  

Effectively communicates with patient/family the POC and progression of such. Keeps the patient informed ongoing. 

Effectively communicates with other disciplines in the case (actively participates in case conferencing) to effectively and appropriately problem solve as situations arise. 

Communicates effectively with the supervising RN, scheduled visits planned and changes to the schedule on a weekly basis. Caseload is self-scheduled but communication of the clinician’s schedule to the nursing supervisor is essential. 

Communicates in case conferencing sessions. Effectively functioning as an involved team member to collaborate on best practices for the individual patient’s needs.

Submits accurate, complete paperwork at the end of every week so that all medical records are intact and up to date. Uses the drop box if the office is already closed for the weekend. 

Notifies the supervising RN with requests for re-authorization of “more visits needed” prior to third party insurers authorized number of visits expiring. 

Suggests Community Services that may be available to the patient to assist in safe home care needs. 

Participates in the Performance Improvement Committee process as requested. 

Participates in staff meetings. Adjusts visits on the staff meeting day to accommodate this function. 

Participates in the growth of the office by being a willing preceptor for newly hired, same discipline employees. 

Maintains LVN licensure and actively seeks out educational experiences to enhance the practice of home care nursing for her/him and the benefit of the patients serviced. 

Notifies the Agency of emergencies, sickness, and other imminent occurrences that may affect the patient caseload as quickly as possible relative to the event’s occurrence. 

Submits written time requests 2 weeks or more in advance of planned time off. 

Other duties as assigned

SPECIAL EQUIPMENT TO BE OPERATED :

Vehicle to do routine patient visits, possible transfer/lifting devices, medical supplies 

WORK ENVIRONMENT :

Indoors, performing patient care assessment/tasks in the patient’s residence 

Travel to patient residences/meetings; will require transportation to get to various work sites 

Possible exposure to communicable diseases 

FUNCTIONAL ABILITIES :

Able to access patient’s homes that may not be handicap accessible. 

Able to hear, speak, understand and communicate effectively in English.

PHYSICAL REQUIREMENTS  :

On a daily basis: walking, standing, sitting, reaching, use of telephone, use of computers & other office equipment, lifting/transferring 150 lbs or greater, bending, stooping, climbing stairs 

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