ZipRecruiter

Log In

1

Prior Authorizations Nurse Jobs (NOW HIRING)

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...

next page

Showing results 1-20

All JobsPrior Authorizations Nurse Jobs

Prior Authorizations Nurse information

See salary details

$17

$38

$65

How much do prior authorizations nurse jobs pay per hour?

As of Jul 30, 2026, the average hourly pay for prior authorizations nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What is the difference between Prior Authorizations Nurse vs Utilization Review Nurse?

AspectPrior Authorizations NurseUtilization Review Nurse
CredentialsRN license, possibly certifications in case managementRN license, certifications in case management or utilization review
Work EnvironmentHealthcare facilities, insurance companies, or outpatient settingsHospitals, insurance companies, or healthcare organizations
Job FocusSecuring prior approvals for treatments or proceduresAssessing medical necessity and reviewing patient cases for ongoing care
Common UsageUsed in insurance and healthcare to obtain treatment approvalUsed in case management and quality assurance to evaluate care appropriateness

The main difference is that a Prior Authorizations Nurse primarily focuses on obtaining approval for specific treatments or procedures before they are performed, while a Utilization Review Nurse evaluates ongoing patient cases to determine the necessity and appropriateness of continued care. Both roles require RN licensure and related certifications, but their daily tasks and focus areas differ within the healthcare and insurance industries.

What are some common challenges faced by Prior Authorizations Nurses, and how can they be addressed?

Prior Authorizations Nurses often encounter challenges such as navigating complex insurance requirements, managing high volumes of authorization requests, and ensuring timely approval to avoid treatment delays. Staying organized and up-to-date on payer policies is crucial, as is effective communication with providers and insurance representatives. Building strong relationships with both clinical teams and payers can help streamline processes and reduce administrative burdens, ultimately improving patient care outcomes.

What are the key skills and qualifications needed to thrive as a Prior Authorizations Nurse, and why are they important?

To thrive as a Prior Authorizations Nurse, you need a valid RN or LPN license, a strong understanding of insurance guidelines, and expertise in clinical documentation. Familiarity with prior authorization software, electronic health records (EHRs), and payer-specific systems is typically required. Attention to detail, strong communication skills, and the ability to multitask efficiently help nurses excel in reviewing medical necessity and advocating for patients. These skills are crucial to ensure timely approvals, minimize delays in patient care, and maintain compliance with regulatory and insurance requirements.

What are Prior Authorizations Nurses?

Prior Authorizations Nurses are registered nurses who specialize in reviewing and processing requests for medical procedures, treatments, or medications to ensure they meet insurance coverage guidelines. They assess clinical documentation, communicate with healthcare providers, and submit necessary paperwork to insurance companies for approval. This role helps ensure that patients receive timely care while complying with payer requirements, reducing delays in treatment and managing healthcare costs.
More about Prior Authorizations Nurse jobs
What cities are hiring for Prior Authorizations Nurse jobs? Cities with the most Prior Authorizations Nurse job openings:
What states have the most Prior Authorizations Nurse jobs? States with the most job openings for Prior Authorizations Nurse jobs include:
What job categories do people searching Prior Authorizations Nurse jobs look for? The top searched job categories for Prior Authorizations Nurse jobs are:
Prior Authorizations Nurse jobs near you
Infographic showing various Prior Authorizations Nurse job openings in the United States as of July 2026, with employment types broken down into 3% Locum Tenens, 1% As Needed, 83% Full Time, 10% Part Time, 1% Temporary, and 2% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

RN Prior Authorizations

Healthcare Support Staffing

Miami, FL

Other

Re-posted 21 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Core duties and responsibilities include the following. Other duties may be assigned.



Supports and encourages others to support the Mission, Core, Values and Goals of Prestige Health Choice.

Conducts occasional facility on-site and/or telephonic concurrent reviews and discharge planning and coordination of assigned hospitals.

Collaborates with follow up appointment coordination activities, and makes necessary referrals to medical and behavioral complex case managers .

Coordinates and supports all discharge authorization and service coordination activities necessary for discharge including inpatient hospital admissions, inpatient rehabilitation services, skilled nursing admission, home care, home care infusion services, outpatient and /or inpatient elective surgery, and referrals for physician consultation with nonparticipating physician offices.

Collaborates with health partners and behavioral Health partners with care coordination, transitions of care, discharges activities and member service issues

Attends facility and health center clinical and provider meetings.

Participates in daily facility rounds, and respective customer clinical and provider services meetings.

Collaborates with hospitalist's networks, and reviews network performance and access.

Monitors performance metrics and operations reports such as bed day, LOS, daily census, discharge and high risk reports.

Assists in coordination of PCP appointments for members prior to discharge

Collaborates with member services and provider operations for network access, authorization inquires, and care coordination.

Collaborates with contracted customer representatives and clinical staff to coordinate and address service and care issues.

Provides operations, performance and summary reports to Director of Inpatient Services.

Meets with Director of Inpatient Services as needed for census and operational updates.

Meets as needed with customer hospitalist networks.

Performs other related duties and projects, as assigned.

Qualifications

**Interqual experience required**

Prior Authorization or concurrent review and case management experience for a health plan/managed care company (at least 3 years)

Knowledge of Windows and Microsoft Office applications.

Current and unrestricted Florida RN license.

Case management and health education experience preferred.

Community and public health experience preferred.

Additional Information


Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

FacebookTwitter

View All Healthcare Support Jobs

Apply