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Prior Authorization Rn Jobs in Rochester, NY (NOW HIRING)

Registered Nurse

Rochester, NY · On-site

$75K - $83K/yr

Ensure all care delivery is compliant with the care plan, authorized tasks, and scope-of-practice ... Active New York State Registered Nurse (RN) license. * Experience in home care, community health ...

Registered Nurse

Rochester, NY · On-site

$75K - $83K/yr

Ensure all care delivery is compliant with the care plan, authorized tasks, and scope-of-practice ... Active New York State Registered Nurse (RN) license. * Experience in home care, community health ...

Registered Nurse

Rochester, NY · On-site

$75K - $83K/yr

Position Summary The RN Case Manager is responsible for completing initial and ongoing nursing ... Ensure all care delivery is compliant with the care plan, authorized tasks, and scope-of-practice ...

Registered Nurse

Rochester, NY · On-site

$75K - $83K/yr

Ensure all care delivery is compliant with the care plan, authorized tasks, and scope-of-practice ... Active New York State Registered Nurse (RN) license. * Experience in home care, community health ...

Registered Nurse (RN) Supervisor - Nights Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Nights Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Nights Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Nights Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Weekends Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Weekends Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Weekends Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Weekends Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor - Weekends Rochester Center for Rehabilitation and Nursing is ... The ideal candidate will have prior Long-term Care experience and excellent communication skills!

Registered Nurse (RN) Supervisor Ontario Center for Rehabilitation and Nursing is actively seeking ... The ideal candidate will have prior supervisor experience in long-term care and strong ...

Registered Nurse (RN) Supervisor Ontario Center for Rehabilitation and Nursing is actively seeking ... The ideal candidate will have prior supervisor experience in long-term care and strong ...

Registered Nurse (RN) Supervisor Ontario Center for Rehabilitation and Nursing is actively seeking ... The ideal candidate will have prior supervisor experience in long-term care and strong ...

Registered Nurse (RN) Supervisor Ontario Center for Rehabilitation and Nursing is actively seeking ... The ideal candidate will have prior supervisor experience in long-term care and strong ...

Showing results 21-40

Prior Authorization Rn information

See Rochester, NY salary details

$7

$41

$71

How much do prior authorization rn jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for prior authorization rn in Rochester, NY is $41.70, according to ZipRecruiter salary data. Most workers in this role earn between $31.11 and $49.38 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.
What are the most commonly searched types of Prior Authorization Rn jobs in Rochester, NY? The most popular types of Prior Authorization Rn jobs in Rochester, NY are:
What are popular job titles related to Prior Authorization Rn jobs in Rochester, NY? For Prior Authorization Rn jobs in Rochester, NY, the most frequently searched job titles are:
What cities near Rochester, NY are hiring for Prior Authorization Rn jobs? Cities near Rochester, NY with the most Prior Authorization Rn job openings:
Infographic showing various Prior Authorization Rn job openings in Rochester, NY as of August 2026, with employment types broken down into 2% As Needed, 61% Full Time, 29% Part Time, and 8% Contract. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $86,736 per year, or $41.7 per hour.

Registered Nurse (RN)

Sodus Rehab & Nursing Center

Williamson, NY • On-site

$15K/mo

Other

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago


Job description

"Competitive Rate"

Full-Time, Part-Time, Per-Diem Available

Shifts: Day/Eve & Nights -

Sign on Bonus:

Part time evening RN $7,500

Full time evening  RN $15,000

Part time overnight  RN $10,000

Every Saturday/Sunday 30 hours  RN $15,000

We offer the Following:

  • Premium Compensation

  • Great Benefits Package

  • Fun, Family-Like Team, and Atmosphere!

  • Work in a Beautifully Remodeled Office

  • Professional Growth & Stability

  • Innovative Training Programs

Benefits:

  • 401(k)

  • Dental insurance

  • Health insurance

  • Paid time off

  • Vision insurance

RESPONSIBILITIES:

· Plan and conduct shift staff meetings on a regular basis to assist in identifying, correcting problem areas in the improvement of services

· Identify problems or potential problems in the delivery of nursing care to residents and implement corrective action immediately

· Make written and oral reports/recommendations to the Director of Nursing as necessary

· Assist in developing methods for coordinating nursing services with other resident services to ensure the continuity of the resident's total regimen of care

· Begin investigation of all accidents, including staff interviews, data gathering and report writing

· Interpret the nursing department's policies and procedures to personnel, resident, visitors, and government agencies as required

· Delegate to each Charge Nurse the administrative authority, responsibility, and accountability necessary to perform his/her assigned duties

· Make daily rounds of assigned units at a minimum at the beginning and end of the shift, depending upon the activity of the units

· Ensure that emergency equipment/supply checks are done each shift

· Participate in the orientation program for new assigned nursing staff to facilitate their assimilation into the workplace within a reasonable time span and to ensure that each staff member understands his/her role, responsibilities and standards of performance

· Complete written performance evaluations on the assigned staff following probation and thereafter annually, and when performance dictates the need, complete additional evaluations

· Initiate corrective and progressive disciplinary action, as needed

· Ensure that all nursing service personnel comply with the policies and procedures, including dress code as set forth in the Nursing Procedure Manual

· Ensure that an enough nursing staff are scheduled and available for your/next tour of duty to ensure that quality care is maintained, and nursing care needs of the patient/resident are met

· Plan, schedule and conduct unit-based in-services as needs are identified

· Monitor assigned personnel to ensure that they are following established procedures in the use of equipment

· Monitor nursing procedures to ensure that nursing service supplies are used in an efficient manner to avoid waste

· Oversee the nursing care to patients/residents to ensure safe, efficient, and customer-oriented services are always delivered.

· Ensure that rooms are ready for the new admission

· Visit resident on report daily to observe and evaluate each resident's physical and emotional status

· Review the nurse's notes to ensure that they are informative and descriptive of the nursing care being provided

· Start and restart IV’s when ordered and when necessary

· Assist the staff nurses in monitoring seriously ill resident

· Ensure that all nurses on your shift comply with the written procedures for the administration, storage and control of medications and supplies

· Monitor medication passes and treatments to ensure compliance with physician orders and facility policy

· Review medication administration records (MAR) for completeness of information, accuracy in the transcription of physician orders

· Inspect nursing treatment areas daily, such as clean utility room, to ensure that they are maintained in a clean and safe manner

· Participate in the implementation of facility quality improvement program for the nursing service department

· Participate in facility surveys (inspections) made by authorized government agencies as requested by the Administrator or Director of Nursing

· Attend and actively participate in various committee meetings such as Infection Control, Safety, and Performance Improvement as requested

· Participate in and adhere to employee health, safety, security and corporate compliance programs and activities

· Participate in the implementation and maintenance of the Infection Control program for monitoring and/or reporting communicable and/or infectious diseases among resident and personnel

· Ensure that personnel follow the established procedures for the use and disposal of personal protective equipment

· Report malfunction of equipment and/or broken furniture immediately to Maintenance Department

· Receive annual physical including appropriate screening for tuberculosis

· The ability to conduct all activities within the resident abuse prevention manual

· Cooperate with investigations regarding employee health, safety, security, and corporate compliance programs

· Report all accident and incidents to Supervisor immediately upon occurrence

· Correct unsafe or hazardous condition encountered, if unable to correct, report condition to immediate Supervisor upon discovery

· Conduct all activities within established safety, security and infection control procedures and guidelines Conducts all activities within established corporate compliance policies and procedures

· Observe and respond to all standing security precautions, devices, and alerts as they pertain to work and common area

· Respond to fire/disaster drills and emergencies

· Ensure that all personnel performing tasks that involve potential exposure have attended the appropriate in-service training prior to performing such tasks

· Ensure that the assigned nursing personnel follow established infection control procedures when isolation precautions become necessary

· Ensure that personnel follow the established procedures for the use and disposal of personal protective equipment

· Ensure that all residents are wearing appropriate identification bracelets

· Assist in the Quality Assurance and Performance Improvement (QAPI) process

QUALIFICATIONS:

EDUCATION / EXPERIENCE:

· Bachelor of Science in Nursing (preferred)

· Current registration and license to practice as a Registered Nurse in the state employed in

· Peripheral IV certification

· Two years of clinical nursing experience

· One-year experience in a management position preferred

· One-year experience in geriatrics and subacute population

· CPR/BLS certified

"Competitive Rate"

Full-Time, Part-Time, Per-Diem Available

Shifts: Day/Eve & Nights

Sign on Bonus:

Part time evening RN $7,500

Full time evening  RN $15,000

Part time overnight  RN $10,000

Every Saturday/Sunday 30 hours  RN $15,000

We are an Equal Opportunity Employer –M/F/D/V

ACKNOWLEDGEMENT

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. All pay rates and bonuses are paid and/ or awarded to employees based on the facilities policy and/ or the CBA, depending on the position.

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