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Remote Prior Authorization Nurse Jobs in Delaware

Prior experience leading crews and mentoring field technicians * Ability to develop and execute ... Legally authorized to work in the United States * Available for extended and irregular hours as ...

Senior Global Program Manager

Wilmington, DE · On-site +1

$96K - $133K/yr

... remote. Hours: 6:00am 3:00pm - Bachelor's degree in a relevant field or equivalent experience ... prior experience in a customer service environment. - Customer Success experience preferred ...

Remote Prior Authorization Nurse information

See Delaware salary details

$17

$38

$65

How much do remote prior authorization nurse jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for remote prior authorization nurse in Delaware is $38.65, according to ZipRecruiter salary data. Most workers in this role earn between $29.62 and $43.32 per hour, depending on experience, location, and employer.

What is a remote prior authorization nurse?

A Remote Prior Authorization Nurse is a registered nurse (RN) or licensed practical nurse (LPN) who reviews medical insurance requests to determine if they meet coverage criteria. They work remotely to assess patient records, collaborate with healthcare providers, and communicate approval or denial decisions based on insurance guidelines. Their role helps ensure patients receive necessary treatments while managing costs for insurance companies. Strong clinical knowledge, attention to detail, and familiarity with insurance policies are essential for this position.

What does a remote prior authorization nurse do?

A typical day for a Remote Prior Authorization Nurse involves reviewing medical records and provider documentation, communicating with physicians or healthcare providers to gather additional information, and submitting authorizations to insurance companies. You may spend much of your time using specialized software to track requests, document outcomes, and ensure compliance with payer guidelines. Collaboration is often required with case managers, providers, and insurance representatives to resolve questions and expedite approvals. While the work is primarily independent, staying organized and communicating effectively with the healthcare team are essential for success in this remote position.

What are the key skills and qualifications needed to thrive as a remote prior authorization nurse?

To thrive as a Remote Prior Authorization Nurse, you need a current RN license, knowledge of medical terminology, and experience with insurance or utilization review processes. Familiarity with prior authorization software, electronic medical records (EMRs), and payer systems is typically required, along with certifications like CCM or CPUR as a plus. Strong attention to detail, organizational skills, and effective written communication are valuable soft skills for this role. These skills are crucial to ensure accurate and efficient authorization of healthcare services, reduce claim denials, and facilitate patient care in a remote setting.

What are popular job titles related to Remote Prior Authorization Nurse jobs in Delaware?

For Remote Prior Authorization Nurse jobs in Delaware, the most frequently searched job titles are:

Infographic showing various Remote Prior Authorization Nurse job openings in Delaware as of August 2026, with employment types broken down into 13% As Needed, 61% Full Time, 13% Part Time, and 13% Contract. Highlights an 100% Remote job distribution, with an average salary of $80,391 per year, or $38.6 per hour.

Advanced Practice Nurse (Nurse Practitioner) - Gastroenterology

Veterans Health Administration

Wilmington, DE • On-site, Remote

$127K - $176K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 3 days ago. Applications are no longer accepted.


Veterans Health Administration rating

8.1

Company rating: 8.1 out of 10

Based on 1,006 frontline employees who took The Breakroom Quiz

67th of 898 rated healthcare providers


Job description

Summary
The Wilmington VA Medical Center is looking to hire a full-time Advanced Practice Nurse (Nurse Practitioner) -Gastroenterology. The Advanced Practice Nurse (APN) practices in Specialty Service to provide a full range of services emphasizing quality, timeliness, and the advancement of the Veterans Affairs (VA) mission. The NP provides advanced clinical practice, consultation, and management.
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Duties
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The NP is a licensed independent practitioner with advanced education and national certification who provides evidence-based care for a population of patients.
Major duties and responsibilities of the position:
  • Independently manages a panel of patients with acute and chronic health conditions with an emphasis on health promotion and disease prevention using evidence-based practice.
  • Develops and implements an individualized plan to achieve optimal population health and disease management.
  • Demonstrates leadership and works collaboratively with the interdisciplinary team.
  • Orders and interprets labs, tests, and diagnostic studies.
  • Prescribes pharmacologic and non-pharmacologic interventions.
  • Initiates referrals and consults to specialty services.
  • Provides education to patients and their families.
  • Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes.
  • Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards
Pay: Competitive salary, regular salary increases, potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory
Work Schedule: Monday - Friday, 8:00am - 4:30pm. This may change depending on the needs of the Veterans.
Telework: Ad-hoc Telework Only
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
Requirements
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Conditions of employment
  • U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
  • English Language Proficiency. In accordance with 38 U.S.C. 7402(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Selective Service Registration is required for males born after 12/31/1959.
  • Subject to background/security investigation.
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Must pass pre-employment physical evaluation/examination.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
  • You may be required to serve a probationary period.
  • Complete all application requirements detailed in the "Required Documents" section of this announcement.

Qualifications
Advanced Practice Nurse (Nurse Practitioner) Basic Requirements
  • Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant:
    • The Accreditation Commission for Education in Nursing (ACEN) or
    • The Commission on Collegiate Nursing Education (CCNE).
    • NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
  • License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
  • Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), Acute Care Nurse Practitioner (ACNP), Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), or Gerontology Nurse Practitioner (GNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.
The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).
  • Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
  • Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
  • Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
    • Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
    • Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
    • Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
    • Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
    • Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:
  • Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
  • Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
  • Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
    • Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
    • Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
    • Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
    • Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
    • Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork

Physical Requirements: This work is mostly sedentary and requires some standing, bending and carrying light items. The incumbent must have the ability to stand and walk for prolonged periods of time to interact with the patients and other services.
Additional information
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.
If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.
Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
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Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
Benefits
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A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
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Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

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About Veterans Health Administration

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The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, serving millions of Veterans each year. Located in Phoenix, AZ, and many other parts of the US, the VHA operates under the Department of Veteran Affairs, as suggested by their official website va.gov. The VHA is dedicated to providing the highest level of comprehensive care to its veterans. The organization offers a broad spectrum of medical, surgical, and rehabilitative care, including mental health services, research, and pharmacy benefits.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Phoenix, AZ, US