Prior Authorization Nurse

IMCS Group; Ohio; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company in healthcare is seeking a Clinical Review Nurse for prior authorization processes in Ohio. The role involves reviewing Medicaid requests, assisting with backlogs, and requires a nursing degree along with relevant experience. This contract position offers a competitive hourly wage and is designed for a mid-senior level professional.

Qualifications

• Requires 2-4 years of related experience.
• Current State Nursing Licensure.

Responsibilities

• Review prior auth requests for Medicaid Line of Business.
• Assist the PA Team in reviewing a backlog of requests.
• Process up to 18 authorizations per day.

Skills

Medical knowledge

Care manager or clinical nursing experience

Education

Graduate from an Accredited School of Nursing or bachelor’s degree in nursing

Job description

This range is provided by IMCS Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$40.00/hr - $42.00/hr

Direct message the job poster from IMCS Group

Dedicated Manager Leading Service Delivery Success In US Recruitment | Enhancing Processes & Fostering Relationships

Job Title: Clinical Review Nurse - Prior Authorization

Duration: 06 months Contract (Potential to Extend)

Desired Start Date- End Date: 8/4/2025 - 2/4/2026

Location: Remote- Ohio

Shift Type: 8am-5pm

Job Duties:

Review of prior auth requests for Medicaid Line of Business.

To assist the PA Team reviewing a backlog of requests from providers.

Biweekly team huddles (virtual), and attention to emailed team instructions, proficient in toggling between multiple systems.

Additional business needs for support

Quality documentation

Timely processing of up to 18 authorizations per day on average.

Skills:

Medical knowledge

Care manager or clinical nursing experience

Licensure Required:

Current State Nursing Licensure.

Education:

Requires Graduate from an Accredited School of Nursing or bachelor’s degree in nursing and 2 – 4 years of related experience.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Insurance

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