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Remote Prior Authorization Rn Jobs in Green Bay, WI

State of Wisconsin

Licensed Practical Nurse

Green Bay, WI · On-site +1

$38.59/hr

The LPN is responsible for performing duties assigned by the registered nurse including assisting ... Job Details Applicants must be legally authorized to work in the United States (i.e. a citizen or ...

Bellin

RN | Virtual Nursing (Onsite)

Green Bay, WI · On-site +1

The Virtual Registered Nurse (VRN) will manage and deliver remote patient care in an acute setting. As an integral part of the patient care team, the VRN collaborates and communicates effectively ...

Adecco

Pharmacist Pipeline Green Bay WI

Green Bay, WI · On-site +1

$55 - $57.75/hr

Adecco Healthcare & Life Sciences is hiring remote pharmacists! For this role you must reside ... reviewing prior authorizations and receiving phone calls from prior authorization pharmacy ...

ThedaCare

Home Health Case Manager (Remote)

Appleton, WI · On-site +1

The Home Health Case Manager (Remote) plays a crucial role in collaborating with health care team ... Licensure - Current Wisconsin RN license * Certifications - American Heart Association Healthcare ...

MDS Solutions

REMOTE MDS Coordinator

Green Bay, WI · Remote

$33.25 - $42.50/hr

The role of the Remote MDS Coordinator is to work with our contract partners to plan, organize, and ... Nursing Experience in MDS Assessment: 3+ year * RN required * RAC-CT preferred * Thorough ...

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Remote Prior Authorization Rn information

See Green Bay, WI salary details

$7

$41

$70

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

As of Jul 26, 2026, the average hourly pay for remote prior authorization rn in Green Bay, WI is $41.09, according to ZipRecruiter salary data. Most workers in this role earn between $30.62 and $48.65 per hour, depending on experience, location, and employer.

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.

What are popular job titles related to Remote Prior Authorization Rn jobs in Green Bay, WI? For Remote Prior Authorization Rn jobs in Green Bay, WI, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization Rn jobs in Green Bay, WI look for? The top searched job categories for Remote Prior Authorization Rn jobs in Green Bay, WI are:
What cities near Green Bay, WI are hiring for Remote Prior Authorization Rn jobs? Cities near Green Bay, WI with the most Remote Prior Authorization Rn job openings:
Remote Prior Authorization Rn jobs near you
Infographic showing various Remote Prior Authorization Rn job openings in Green Bay, WI as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $85,465 per year, or $41.1 per hour.
RN Coordinator Utilization Management

RN Coordinator Utilization Management

Network Health WI

Menasha, WI • On-site, Remote

Full-time

Posted 19 days ago

Job description

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha is required occasionally for the position, including on first day. Training is required in person at our Menasha location for the first 6-8 weeks.
Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday
Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.
Job Responsibilities:
  • Evaluate and process prior authorization requests/referrals submitted from contracted and non-contracted providers
  • Follow Network Health process, policies, and procedures in authorization review of all membership on a pre-service, concurrent and post-service basis. This process includes verifying eligibility and benefits, as well as documenting all utilization management communication
  • Provide education regarding utilization management activities and processes to members, caregivers, providers, and their administrative staff
  • Participate in Utilization Management auditing (i.e. Utilization Management Inter-reviewer reliability and denial files)
  • Refer all members with complex health problems and needs to Network Health Case Management to reduce medical costs while providing a higher quality of life and an ability to take charge of their diseases. This requires an extensive holistic approach to care management assessment
  • Collaborate with other NH departments to develop interdepartmental operational processes
  • Support Utilization Management department programs and goals through active participation
  • Identify and screen candidates for Case Management intervention and determines appropriate level of care from Utilization Management criteria
  • Complete assessments and plans of care including need for medication regime, treatment plans, practitioner follow-up appointments, knowledge of red flags, disease management, Advance Directives, life planning, and self-management of illness to the best of member ability
  • Evaluate cases for cost savings/quality improvement potential
  • Other duties and responsibilities as assigned

Job Requirements:
  • Bachelor of Science in Nursing, preferred
  • Associate Degree in Nursing, required
  • Current registered nurse licensure in Wisconsin required
  • Minimum of four (4) years clinical health care experience as a Registered Nurse (RN) required
  • Experience in insurance, managed care and utilization management preferred

Network Health is an Equal Opportunity Employer
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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