Remote Prior Authorization RN — Impactful Care

Actalent; United States; Remote; USD 52,000 - 61,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) plan

Life Insurance

Short & long-term disability

Health Spending Account

Transit benefits

Employee Assistance Program

Paid time off

Job summary

Actalent is seeking an experienced Registered Nurse to join a remote Prior Authorization team supporting Dual Eligible populations. You will review outpatient authorization requests, assess medical necessity, apply guidelines, and ensure timely access to care.

This is a fully remote,Contract-to-Hire role out of Sunrise, FL, with the potential for long-term placement. Ideal candidates hold an RN license with 2–4 years in clinical review or utilization management, and a Bachelor’s in Nursing from

Qualifications

• RN license required.
• Bachelor's degree in Nursing or accredited nursing program.
• 2–4 years in clinical review, utilization management, prior authorization, or case management.

Responsibilities

• Perform medical necessity and clinical reviews of authorization requests.
• Collaborate with providers and the authorization team for timely reviews.
• Coordinate with interdepartmental teams to assess medical necessity of care.
• Escalate PA requests to Medical Directors when needed.
• Assist with service authorization for transfers or discharge planning.

Skills

RN license

Nursing degree

Clinical review

Utilization management

Education

Bachelor's of Nursing

Tools

Health management systems

Job description

Actalent is seeking an experienced Registered Nurse to join a remote Prior Authorization team supporting Dual Eligible populations. You will review outpatient authorization requests, assess medical necessity, apply guidelines, and ensure timely access to care.

This is a fully remote,Contract-to-Hire role out of Sunrise, FL, with the potential for long-term placement. Ideal candidates hold an RN license with 2–4 years in clinical review or utilization management, and a Bachelor’s in Nursing from