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Remote Prior Authorization Rn Jobs in New York (NOW HIRING)

Susquehanna University

Registered Nurse

Manhattan, NY · On-site +1

$95K - $101K/yr

Operations Process and sign medication orders, complete medication refills, and prior authorization ... Registered Nurse Licensure CPR/First Aid Certification Ability to communicate and engage ...

Susquehanna University

Registered Nurse

Manhattan, NY · On-site +1

$95K - $101K/yr

Operations Process and sign medication orders, complete medication refills, and prior authorization ... Registered Nurse Licensure CPR/First Aid Certification Ability to communicate and engage ...

Vynca

Registered Nurse

Hackensack, NJ · Remote

$48 - $52/hr

Remote work experience. Additional Information * The hiring process for this role may consist of ... be required prior to employment. * Scope: This is not exhaustive and may include additional ...

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All JobsRemote Prior Authorization Rn JobsRemote Prior Authorization Rn Jobs in New York

Remote Prior Authorization Rn information

What is the difference between Remote Prior Authorization Rn vs Remote Medical Coder?

AspectRemote Prior Authorization RnRemote Medical Coder
CredentialsRN license, certification in case management or utilization reviewCertification in coding (CPC, CCS), high school diploma or equivalent
Work EnvironmentHealthcare facilities, insurance companies, telehealthMedical offices, insurance companies, remote coding platforms
Industry UsageUtilization review, patient authorization, insurance approvalMedical record review, billing, coding for insurance claims

Remote Prior Authorization Rns focus on reviewing patient information to approve treatments, while Remote Medical Coders translate medical records into codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare industry.

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Remote Prior Authorization Rn jobs near you
Workers' Compensation Nurse Case Manager

Workers' Compensation Nurse Case Manager

The Black Car Fund

Long Island City, NY • On-site

$105K - $115K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

Job description

Join Our Team at The Black Car Fund: New York Workers' Compensation Nurse Case Manager
Hybrid (Long Island City, NY) or Fully Remote (for candidates living 75 miles or more from Long Island City)
$105,000 - $115,000 + $2,500 Signing Bonus
Make an Impact on Where It Matters
At The Black Car Fund, we don't just manage claims, we support the drivers who keep New York moving. As a not-for-profit dedicated to providing workers' compensation insurance, safety education, and benefits to For-Hire drivers, our work directly affects thousands of lives every day.
We are looking for an experienced New York Workers' Compensation Nurse Case Manager or an experienced Registered Nurse who is willing to train and become a Certified Workers' Compensation Nurse Case Manager (CCM). The selected candidate will be detail-driven and people-focused, delivering meaningful outcomes.
Why This Role Stands Out
  • Mission-driven work that supports essential workers.
  • Flexible work environment (hybrid or fully remote)
  • Competitive compensation + signing bonus
  • Growth opportunities within a collaborative, forward-thinking team

What You will Do
Early intervention for medical case management on select workers' compensation claims:
  • Manage and process Prior Authorization Requests, also known as PARs, submitted by the treating providers through the OnBoard system.
  • Provide case management in a workers' compensation environment. Document assessment and care plan of the IW to collect information needed to formulate a claim plan collaboratively.
  • Develop appropriate treatment plans with a balance between quality of care and cost-effectiveness that meets a universally accepted medical and disability duration guideline. (ODG/Presley Reed)
  • Adhere to URAC (Utilization Review Accreditation Commission) standards. Certification preferred but not required.
  • Provide appropriate Utilization and Review of treatment under the NYS Medical Treatment Guidelines and recommend approval or denial to claims adjusters based on medical documentation, the guideline(s), and nursing Standards of Care.
  • Collaborate with members of the Claims Team and Nursing Team.
  • Participate in file reviews and roundtables on complex and catastrophic cases.
  • Provide documentation that is clear, concise, and reflects strong technical and clinical knowledge with nursing assessments and action plans.
  • Provide effective vendor management when assessing or managing cases.
  • Serve as an informational and medical resource for the Claims Management staff.
  • Provide claim review services on cases as needed, as per BCF policy and procedure.
What You Bring
You are a nursing professional who thrives in a demanding environment and knows how to balance medical expertise with sound judgment.
Required:
  • Candidate must present documentation to verify the minimum school educational requirement.
  • Candidates are subject to a 90-day evaluation period.
Experience / Certifications / Skills:
  • An associate or bachelor's degree in nursing required; Registered Professional Nurse in NYS required
  • Five or more years of clinical nursing experience are preferred.
  • CCM (Certified Case Manager) or COHN (Certified Occupational Health Nurse) preferred but not necessary.
  • Candidates without either a CCM or COHN must confirm their intent to work toward certification.
  • URAC standards understanding and/or certification preferred.
  • Demonstrate completion of the NYS Workers' Compensation Medical Treatment Guideline online training.
  • Knowledge of New York workers' compensation, disability, and managed care law is preferred.
  • Customer Focus: provides outstanding customer service, listens, and maintains composure in all situations and involves others when appropriate; interpersonal/savvy - relates well with people with diverse backgrounds and can build appropriate rapport.
  • Composure: Is cool under pressure; does not become defensive or irritated in tough situations.
  • Effective communication: Communication style that adjusts delivery to reach different audiences; strong verbal (phone) and written communication skills; ability to deliver difficult information, plus excellent decision-making and critical thinking skills.
  • Multi-tasking: Ability to adapt to changing priorities while maintaining a positive attitude.
  • Time Management: Ability to coordinate services, tasks, and reports promptly.
  • Proficient in current Microsoft Office Suite programs
Medical specialties:
  • Critical & Intensive Care
  • Medical-Surgical
  • Occupational Medicine
  • Physical & Rehabilitation Medicine
  • Primary Care
  • Surgery

If you are looking for a role where your expertise is truly valued and where flexibility, purpose, and professional growth come together, we would love to hear from you.
Why You Will Love Working with Us:
We are committed to creating a supportive, rewarding, diverse environment where your contributions truly matter. Here is what you can expect as a member of our team:
  • Competitive Salary: $105,000 - $115,000 per year.
Generous Benefits:
  • Health Care Benefits with limited employee contribution. One of our health plans requires no contribution. All plans cover eligible family members at similar rates.
  • 401(k) with 100% employer match (up to 6% of salary).
  • ROTH 401(k)
  • 100% employer-paid Life Insurance, Dental, and Vision coverage.
  • Paid Vacation & Sick Time, plus Pre-tax Transit Benefits.
  • Flexible Spending Account allows you to use pre-tax monies to pay unreimbursed medical and dependent care expenses.
  • Lifestyle Spending Account allows you to use pre-tax monies for expenses incurred in a wide variety of categories, including sports equipment, utility bills, and auto expenses.
  • Pet Discount Program covers any pet, regardless of breed, health, or age!
  • Employee Assistance Plan available on a confidential basis.
  • $2500 Signing Bonus to welcome you to the team!
  • Work-Life Balance: Hybrid (for residents) work schedule after training.
  • Team-Oriented Culture: We foster a collaborative environment with opportunities for growth through team-building exercises and training.
  • Career Growth Opportunities: The Black Car Fund supports your professional development through ongoing education and skills training.
Qualifications & Requirements:
  • Education: BSN preferred; associate or bachelor's degree in nursing required. A New York State nursing license is required.
  • Experience: 5+ years of experience as a Nurse Case Manager or relevant practical experience.
  • Location: Hybrid or Remote position.
    • For those who live within 75 miles of Long Island City, a hybrid work schedule is offered.
    • If you live more than 75 miles from Long Island City, a remote work schedule is offered.
Who Should Apply:
The Black Car Fund is an equal-opportunity employer, and we strongly encourage qualified military veterans and spouses to apply. We value diversity and are committed to creating an inclusive work environment where everyone can thrive.
If you're ready to bring your skills, enthusiasm, and passion to a meaningful role, apply now to join our team at The Black Car Fund, one of the Top Places to Work in New York by City & State New York, and named one of the Best Companies to Work For in New York in 2026 by Best Companies Group!

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