Prior Authorization Registered Nurse (RN)

Job overview

The Prior Authorization Registered Nurse (RN) role is onsite in Chandler, AZ for the first 60 days, with a hybrid schedule available after the initial training period. Compensation is $40–$42 per hour. Arizona Priority Care focuses on whole-person care for senior and Medicaid populations through value-based care models. The RN conducts initial clinical reviews of preservice authorization requests to support continuity of care and appropriate service utilization. The role prepares cases for utilization management reviewers, supports timely and compliant decisions, and contributes to quality improvement and efficient daily operations.

What you'll do

• Monitor prior authorization and pharmacy request queues
• pre-screen requests and obtain missing information
• apply health plan criteria
• conduct clinical reviews and approve requests when appropriate
• prepare cases for Medical Director review
• compose compliant medical necessity denial letters
• process at least 20 requests daily depending on complexity
• maintain a 98% or higher clinical review accuracy rate
• liaise with providers and Medical Directors
• identify potential quality issues
• and protect PHI in accordance with HIPAA policies.

What we're looking for

Skills & competencies

prior authorization registered nurse (rn)

chandler az

arizona priority care

utilization management

clinical review

preservice authorizations

medical necessity

care management

arizona rn license

hybrid after training

$40–$42 per hour

senior and medicaid care

Work arrangement

• Weekend coverage required

Why this role

The posting requires graduation from an accredited Registered Nurse program, a current unrestricted Arizona RN license, and at least three years of acute care or care management experience. Hybrid scheduling is available after 60 days of full-time in-office presence.

About the employer

Arizona Priority Care is hiring for this role. Industry: HMO Medical Centers. Sector: 62.