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Weekend Prior Authorization Nurse Jobs (NOW HIRING)

Care Navigators On Demand

$39 - $45/hr

Prior Authorization RN Case Manager Granada Hills, CA Full-Time Direct Hire Description Therole of the Prior Authorization Nurse Case Manager (PACM) is to promotethe quality and cost effectiveness of ...

BlinkRx

Prior Authorization Specialist

Pittsburgh, PA · On-site

$17.50 - $23.25/hr

We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...

Lifespan

Prior Authorization Coord

Providence, RI · On-site

$19.03 - $31.39/hr

... and prior authorization processes for outpatient radiological services within Brown University ... M-F 9:30am - 6:00 pm occasional weekends Work Shift: Day Daily Hours: 8 hours Driving Required: No

Kaleida Health

Prior Authorization Specialist

Olean, NY · On-site

$17.37 - $23.89/hr

Prior Authorization Specialist Requisition ID#: 21858 Location: Olean, NY Work Type : Full-Time ... Onsite *Pay Range: $17.37 -$23.89 No Nights, Weekends or Holidays! Free Parking! Benefits ...

BlinkRx

Prior Authorization Specialist

Pittsburgh, PA · On-site

$17.50 - $23.25/hr

We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...

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Weekend Prior Authorization Nurse information

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$38

$65

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

As of Jul 14, 2026, the average hourly pay for weekend prior authorization nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What is the difference between Weekend Prior Authorization Nurse vs Weekend Case Manager?

AspectWeekend Prior Authorization NurseWeekend Case Manager
CredentialsRN license, certifications in case management or utilization reviewRN or social work license, case management certification
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, insurance companies, healthcare organizations
Job FocusReview and approve medical procedures for insurance coverageCoordinate patient care, discharge planning, and resource management

The Weekend Prior Authorization Nurse primarily reviews and approves medical procedures for insurance coverage during weekends, focusing on authorization processes. In contrast, the Weekend Case Manager manages patient care plans, discharge processes, and resource coordination. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ significantly.

More about Weekend Prior Authorization Nurse jobs
What cities are hiring for Weekend Prior Authorization Nurse jobs? Cities with the most Weekend Prior Authorization Nurse job openings:
What are the most commonly searched types of Prior Authorization Nurse jobs? The most popular types of Prior Authorization Nurse jobs are:
What states have the most Weekend Prior Authorization Nurse jobs? States with the most job openings for Weekend Prior Authorization Nurse jobs include:
What job categories do people searching Weekend Prior Authorization Nurse jobs look for? The top searched job categories for Weekend Prior Authorization Nurse jobs are:
Weekend Prior Authorization Nurse jobs near you
Infographic showing various Weekend Prior Authorization Nurse job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.
Prior Authorization RN Case Manager-Urgent

Prior Authorization RN Case Manager-Urgent

Care Navigators On Demand

On-site

$39 - $45/hr

Full-time

Re-posted 16 days ago

Job description


Prior Authorization RN Case Manager
Granada Hills, CA
Full-Time
Direct Hire
Description
Therole of the Prior Authorization Nurse Case Manager (PACM) is to promotethe quality and cost effectiveness of medical care by applying clinicalacumen and the appropriate application of policies and guidelines toprior authorization specialty referral requests. The PACM will reviewfor appropriate care and setting, and following guidelines/policies,will approve services when indicated. If not indicated, PACM willforward requests to the appropriate physician or medical director withrecommendations for other determinations, ensuring that the member isreceiving the appropriate quality care in a preferred setting, whilemaking sure regulatory guidelines are followed.
Responsibilities
1.Understand, promote and review with appropriate medical management tofacilitate the right care at the right time in the right setting.
2.Communicate effectively and interact with providers, staff and healthplans daily regarding medical management and referral authorizationissues.
3. Maintain a working relationship with PACMcolleagues, the pre-auth coordinator team, high-risk nurse casemanagers, inpatient nurse case managers, medical directors, and networkmanagement.
4. Research alternative care plans and whennecessary, assist in the routing of members to the most appropriatecare/setting, in order to provide right care/right setting.
5.When necessary, act as liaison between the case managers, UMcoordinators, contracted providers (PCPs/specialists/ancillary), and themembers/families.
6. Perform case reviews based on keyscreening outpatient indicators, and evaluate the PCP submitted plan ofcare for completeness of documentation, consistency of treatment withmedical groups clinical practice guidelines, adherence to standardevidence-based or consensus guidelines, and health plan and CMSguidelines and/or medical policies.
7. Maintain regulatory Turnaround Time Standards per regulatory guidelines.
8. Document accurately and completely all necessary information in authorization notes.
9. Understand all applicable capitation contracts and how they apply to review duties.
10.For those PACMs involved in DME, understand the contracts, and need toreview rental vs. purchase approvals, and continued use so thatequipment is picked up when needed.
11. Whenappropriate, coordinate and review for medical necessity and appropriateutilization any ancillary professional services, i.e. (home health,infusion, PT, OT, ST, etc.).
12. Demonstrates theability to follow through with requests, sharing of criticalinformation, and getting back to individuals in a timely manner.
13.Participates in "service recovery" through follow-up with an upsetpatient or provider, gathering information, and demonstrating empathy.
14. Identifies network needs and reports to management for potential contracting opportunities.
Qualifications
1.Graduated from an accredited Registered Nursing Program
2.Current California RN License
3.Minimum of 1 year acute experience
4.Knowledge of Managed Care preferred.
5.Knowledge of NCQA, CMS, HSAG, and health plan requirements related to utilization management.
6.Knowledgeable with the pre-authorization process and workflow, with prior authorization experience preferred.
7.Knowledgeable in computers and MS Office programs (i.e., Word, Excel, Outlook, Access and Power Point).
8.Ability to deal with responsibility of confidential matters
9.Ability to work in a multi-tasking, fast-paced, high-stress environment.
Compensation
$38-$42/Hr
Negotiable based on experience

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