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Remote Prior Authorization Rn Jobs (NOW HIRING)

Managed Staffing

Licensed Vocational Nurse - LPN

RI · Remote

$28 - $30/hr

Licensed Vocational Nurse (LPN) - Remote Prior Authorization 100% Remote - Anywhere in the U.S. Schedule: Monday-Friday, Day Shift (No weekends unless overtime is required) About the Role We are ...

IVX Health

Prior Authorization Coordinator

$19 - $23.50/hr

Fully Remote, Hybrid, or In-office (Brentwood, TN) * Schedule : Monday - Friday, standard business hours (no nights, weekends, or holidays) What You Will Do * Review and Process Prior Authorizations ...

IVX Health

Prior Authorization Coordinator

$19 - $23.50/hr

Fully Remote, Hybrid, or In-office (Brentwood, TN) * Schedule : Monday - Friday, standard business hours (no nights, weekends, or holidays) What You Will Do * Review and Process Prior Authorizations ...

IVX Health

Prior Authorization Coordinator

Brentwood, TN · On-site +1

$17.50 - $21.75/hr

Fully Remote, Hybrid, or In-office (Brentwood, TN) * Schedule : Monday - Friday, standard business hours (no nights, weekends, or holidays) What You Will Do * Review and Process Prior Authorizations ...

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

Mon-Fri(8:30am to 5pm) This is not a remote opportunity . Applicants must reside in, or commutable ... as skilled nursing facilities, senior living communities, and hospitals. We also cater to ...

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

As of Sep 5, 2026, the average hourly pay for remote prior authorization rn in the United States is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $50.00 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.

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Remote Prior Authorization Rn jobs near you
Infographic showing various Remote Prior Authorization Rn job openings in the United States as of August 2026, with employment types broken down into 82% Full Time, 9% Part Time, and 9% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,868 per year, or $42.2 per hour.

Remote Prior Authorization Pharmacist

Insight Global

Orlando, FL • Remote

$59/hr

Contractor

Medical, Dental, Vision, Life

Posted 12 days ago

Job description

Company: OptumRx

Position: Pharmacist and Certified Pharmacy Technician

Openings: 895 total – 380 Remote Pharmacists and 515 Remote Certified Pharmacy Technicians

Locations: REMOTE across the US working EST, CST or PST

Duration: 6 – 10 months – extensions are based on business demand

  • All contractors are expected to work the full assignment.
  • Some assignments can convert permanent based on business demand and performance.

Start date: Rolling start dates, 8/31-11/23 – all start dates can be found on Airtable.

Schedule: Will vary depending on hiring class, information located on Air Table

  • Lunch is 30 minutes; lunch is not paid.
  • They will get 2, 15-minute breaks.
  • Candidates with no time off request will be prioritized. 100% attendance during training is required. Candidates with more than 3 days off during the contract period will not be considered.

Interview Process: Group interview lead by IG AM and OptumRx

  • 5 Pharm Tech: 1 OptumRx Hiring Manager
  • 3 RPh: 1 OptumRx Hiring Manager


PHARMACIST – RPh

Must Haves

-Bachelors or Doctorate of Pharmacy; Active State Pharmacist License

-Current Licensed Pharmacist within the state of work

-6+ months of customer service/customer relations with healthcare professionals

-Technology savvy - Basic proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document) and basic proficiency with Microsoft Outlook (ability to send emails)

-Comfortable with production-based environment

-Ability to perform responsibilities and duties remotely with little to no supervision

-Comfortable in a fast-paced, high-volume workload

-Ability to be adaptable, team-oriented culture requiring flexibility and adaptability to changing business needs.

 

Job Description:

The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines, pharmacy policies, and health plan benefits. In this fast-paced, high-volume environment, the pharmacist works closely with physicians, healthcare providers, pharmacy technicians, and internal teams to gather and assess clinical information, make evidence-based coverage determinations, recommend formulary-compliant and cost-effective treatment alternatives, and ensure compliance with federal and state regulations. The role requires strong clinical judgment, attention to detail, effective communication skills, and the ability to manage competing priorities while meeting productivity and quality standards. Additionally, the pharmacist supports quality assurance initiatives, resolves provider and pharmacy inquiries, participates in process improvement efforts, and contributes to a collaborative, customer-focused team environment. Maintain full compliance with state and federal pharmacy laws, Medicare Part D, Medicaid, and commercial benefit regulations. Accurately document case decisions in accordance with internal protocols, auditing standards, and confidentiality policies.  Effectively manage case volume by organizing workload, setting daily priorities, and meeting productivity and quality benchmarks. Adapt to fluctuating demands while maintaining accuracy and professionalism under pressure.