Job Description
A-Line Staffing is now hiring a Clinical Review Nurse – Prior Authorization.
This position is a remote opportunity for a major healthcare organization with strong potential for contract-to-hire.
If you are interested in this position, please Apply or Email me with your resume attached at Jmahnke@alinestaffing.com
Clinical Review Nurse – Prior Authorization Compensation
• The pay for this position is $38.00 – $41.00 per hour
• Benefits are available to full-time employees after 90 days of employment
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates
Clinical Review Nurse – Prior Authorization Highlights
• Required availability is Monday–Friday, 8 hours/day (typically 8:00 a.m.–5:00 p.m.)
• No weekend requirement during training; post-training, will work consistent weekday hours
• Remote position – candidates may be sourced nationally , with preference for EST or CST time zones
• Contract-to-hire potential
Clinical Review Nurse – Prior Authorization Responsibilities
• Review authorization requests using evidence-based clinical criteria
• Make determinations regarding medical necessity
• Conduct provider outreach for additional information when needed (no member calls)
• Document reviews accurately using the TruCare system
• Participate in a comprehensive ~4-week training with L&D team
• Shadow experienced RNs to support onboarding
Clinical Review Nurse – Prior Authorization Requirements
• Active RN license (Bachelor’s degree is not required but preferred)
• 2+ years of clinical experience in ICU, acute care, medical-surgical, or home health settings
• Experience in Utilization Review or Prior Authorization
• Comfortable with Microsoft Office and TruCare (preferred)
• Must be based in the U.S.
Clinical Review Nurse – Prior Authorization Preferences
• Medicare Prior Authorization or Utilization Management experience
• CCM or ACLS Certification
• Experience with TruCare platform
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