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Remote Prior Authorization Rn Jobs in San Jose, CA

talentpluto

Account Executive

San Francisco, CA · Remote

$220K - $300K/yr

Remote Industry: Health tech / AI Compensation: $110K-$150K base, $220K-$300K OTE About the Company Our partner is a seed-stage health-tech company using agentic AI to solve prior authorization for ...

talentpluto

Account Executive

San Francisco, CA · On-site +1

$220K - $300K/yr

Remote Industry: Health tech / AI Compensation: $110K-$150K base, $220K-$300K OTE About the Company Our partner is a seed-stage health-tech company using agentic AI to solve prior authorization for ...

Star Nursing, Inc.

Be Seen First

RN Assessment Case Manager

Hayward, CA · Remote

$75/hr

Assessment RN / Case Manager Location ... Alameda County Hybrid Position, Remote and on-site monthly visits Conduct initial and monthly ...

New

Vynca

Clinical Manager (RN)

San Mateo, CA · Remote

$90K - $125K/yr

This is a remote position with up to 25% travel required for trainings, meetings, and other ... Pay for this position will be based on several factors, including, but not limited to: your prior ...

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Remote Prior Authorization Rn information

See San Jose, CA salary details

$8

$49

$84

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

As of Aug 11, 2026, the average hourly pay for remote prior authorization rn in San Jose, CA is $49.51, according to ZipRecruiter salary data. Most workers in this role earn between $36.92 and $58.61 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 San Jose, CA? For Remote Prior Authorization Rn jobs in San Jose, CA, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization Rn jobs in San Jose, CA look for? The top searched job categories for Remote Prior Authorization Rn jobs in San Jose, CA are:
What cities near San Jose, CA are hiring for Remote Prior Authorization Rn jobs? Cities near San Jose, CA 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 San Jose, CA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $102,980 per year, or $49.5 per hour.

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

Molina Healthcare

San Francisco, CA • Remote

$30.37 - $59.21/hr

Full-time

Re-posted 6 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 198 frontline employees who took The Breakroom Quiz

163rd of 304 rated insurance

Job description

JOB DESCRIPTION Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. 
Essential Job Duties 
Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. 
Analyzes clinical service requests from members or providers against evidence based clinical guidelines. 
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. 
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. 
Processes requests within required timelines. 
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. 
Requests additional information from members or providers as needed. 
Makes appropriate referrals to other clinical programs. 
Collaborates with multidisciplinary teams to promote the Molina care model. 
Adheres to utilization management (UM) policies and procedures. 
Required Qualifications 
At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. 
Registered Nurse (RN). License must be active and unrestricted in state of practice. 
Ability to prioritize and manage multiple deadlines. 
Excellent organizational, problem-solving and critical-thinking skills. 
Strong written and verbal communication skills. 
Microsoft Office suite/applicable software program(s) proficiency. 
Preferred Qualifications 
Certified Professional in Healthcare Management (CPHM). 

Utilization review, prior authorization, inpatient review desirable. MCG experience, strongly preferred.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $30.37 - $59.21 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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