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

Angels In Your Home LHCSA

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 ...

Angels In Your Home

Registered Nurse

Rochester, NY

$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 ...

Angels In Your Home

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 ...

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Prior Authorization Rn information

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$41

$71

How much do prior authorization rn jobs pay per hour?

As of Jun 18, 2026, the average hourly pay for prior authorization rn in Rochester, NY is $41.68, according to ZipRecruiter salary data. Most workers in this role earn between $31.06 and $49.33 per hour, depending on experience, location, and employer.

How to make $300,000 a year as a nurse?

A Prior Authorization RN can earn $300,000 annually by gaining extensive experience, obtaining advanced certifications, and working in high-paying settings such as specialty clinics or insurance companies. Increasing workload, taking on leadership roles, or working overtime can also boost income, but reaching this level typically requires a combination of expertise, efficiency, and strategic employment choices.

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.

Can nurses do prior authorizations?

Prior authorization nurses, often called utilization review nurses or case managers, are qualified to handle prior authorization requests. They review medical documentation, communicate with providers and insurance companies, and ensure compliance with payer requirements, often using electronic health record systems. Certification in case management or utilization review can enhance their ability to perform these tasks effectively.

How to make an extra 2000 a month as a nurse?

A Prior Authorization RN can increase income by taking on additional shifts, working overtime, or offering consulting services to healthcare providers. Developing specialized knowledge in insurance authorization processes and obtaining relevant certifications can also lead to higher-paying opportunities or freelance work 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.
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Prior Authorization Rn jobs near you
Infographic showing various Prior Authorization Rn job openings in Rochester, NY as of June 2026, with employment types broken down into 2% As Needed, 60% Full Time, 22% Part Time, 14% Contract, and 2% Summer. Highlights an 94% In-person, 2% Hybrid, and 4% Remote job distribution, with an average salary of $86,696 per year, or $41.7 per hour.
LPN and RN Relief Floater Per Diem

LPN and RN Relief Floater Per Diem

Villa of Hope

Rochester, NY • On-site

$30 - $40/hr

Per diem

Posted 2 days ago

Job description




JOB TITLE: LPN/RN Relief Floater – Per Diem

DEPARTMENT/PROGRAM: Living Hope Treatment Center/ Medical Services

SUPERVISOR: Human Resources

PAYGRADE: $40/hour- RN $30/hour-LPN

FLSA STATUS: Non-Exempt

JOB SUMMARY:

Under the general direction of the program nurse manager, the LPN/RN Relief Floater supports both Medical Services and Living Hope Detox programs by providing high-quality, compassionate nursing care to clients aged 16+. The Relief Floater promotes client health and wellness, completes medical and psychiatric assessments within the appropriate NYS scope of practice, administers medications, monitors withdrawal symptoms, performs health screenings, and supports client stabilization in an integrated behavioral health and substance use treatment setting.

This position functions as a flexible clinical resource, floating between programs and units as needed to ensure adequate coverage, continuity of care, and safe milieu management. The nurse will demonstrate and be accountable to the Agency’s Mission, Vision, Values, Guiding Principles, and Strategic Plan.

ESSENTIAL FUNCTIONS:

Client Care & Assessment

  • Conducts nursing assessments within scope of practice for sick/injured clients and new intakes.
  • Obtains health histories, psychiatric records, communicable disease risk assessments, vital signs, heights, weights, and waist circumference as appropriate.
  • Assesses clients for withdrawal symptoms, psychiatric instability, and medical needs; accurately documents findings and communicates them to the interdisciplinary team.
  • Provides first response to medical or psychiatric issues, using crisis management techniques to de-escalate clients and interactions when needed.
  • Monitors, supports, and provides extra attention to clients at risk for suicidal behavior or leaving against medical advice.
  • Encourages engagement in treatment and models adaptive coping behaviors for clients transitioning out of detox.

Medication & Treatment Responsibilities

  • Administers prescribed medications and treatments in accordance with the 7 Rights of Medication Administration and agency protocols.
  • Transcribes and verifies provider orders accurately and timely.
  • Executes prescribed interventions, including both routine and PRN medications.
  • Performs CLIA-waived tests and documents results per regulatory requirements.
  • Manages medication ordering, storage, and pharmacy deliveries; completes prior authorizations if needed.
  • Maintains infection control standards, universal precautions, and medical asepsis.

Documentation & Communication

  • Accurately documents all assessments, interventions, and observations in electronic clinical records.
  • Ensures all required documentation meets agency, state, and federal requirements including HIPAA and 42 CFR Part 2.
  • Effectively communicates with multidisciplinary treatment teams, including medical, psychiatric, case management, and intake staff.
  • Participates in discharge planning and care-transition coordination.
  • Safety, Compliance & Professional Standards
  • Maintains confidentiality and security of all client and staff information.
  • Fully complies with the Agency Code of Conduct, Justice Center Code of Conduct, and all state/federal regulations.
  • Maintains cultural competency and demonstrates empathy, compassion, and professionalism when working with clients with substance use or psychiatric disorders.
  • Participates in required staff trainings and meetings.
  • Provides support during new hire orientation and supervises nursing students as appropriate.

POSITION SPECIFICS:

Education:

  • Required: Active NYS LPN or RN license.

Experience:

  • Minimum 1 year experience in direct care, preferably with substance use, mental health, or acute care populations.
  • Experience with electronic medical records required.

Skills:

  • Strong clinical skills within the LPN/RN scope of practice, including medication administration, withdrawal monitoring, crisis intervention, and documentation.
  • CPR/First Aid/BLS required; Narcan training preferred.
  • Excellent written and verbal communication abilities.
  • Ability to maintain professional boundaries and demonstrate compassion with clients experiencing withdrawal, psychiatric symptoms, or co-occurring disorders.
  • Valid NYS Driver’s License required.

Physical Demands:

  • Frequent standing, walking (including stairs, hills, and outdoor travel), bending, kneeling, and lifting.
  • - Must be able to lift up to 50 lbs and assist clients weighing up to 200 lbs as necessary.
  • - Must be able to respond quickly to urgent medical needs, including performing CPR.

COMPETENCIES:

Leading Self

  • Character and Courage (Integrity and Trust)-
  • Do the right thing, because it is the right thing, even when no one is looking. Truth to Power.
  • Customer Focus
  • Build positive relationships through communication and collaborative problem solving.
  • Commitment to Diversity, Inclusion, Justice and Equity
  • Believe in the dignity and humanity of all people to reach their full potential.