New

Clinical Review Nurse - Prior Authorization

Spectraforce Technologies

United States, North Carolina, Raleigh

500 West Peace Street (Show on map)

Oct 01, 2026

Position Title: Clinical Review Nurse - Prior Authorization

Work Location: Remote - US MST, CST, EST only

Assignment Duration: 12 Months

Work Schedule: 8 to 5 CST (1 hour lunch)

* Sunday through Thursday or

* Tuesday through Saturday or

* Wednesday through Sunday

No OT

Work Arrangement: Remote

Illinois or Compact license

Position Summary:

Medicaid and Marketplace prior authorization reviews.

This position is needed to support key strategic initiatives and process improvement projects. Dedicated resources are required to ensure project deliverables are met while maintaining day-to-day operational responsibilities.

Background & Context:

Fast-paced and collaborative, focused on regulatory compliance, operational excellence, and delivering timely, accurate authorization decisions.

Multi states with Medicaid and marketplace plans.

Key Responsibilities:

* Review prior authorization requests within turnaround times while maintaining quality standard.

* 14 to 16 reviews per day. Quality score of 95% or higher.

Candidate Requirements
Required: graduated from accredited nursing program or Bachelor's degree in Nursing	Preferred:
Required: LPN or LVN	Preferred: RN
Years of experience required: 2-4 years of related experience Disqualifiers: No Illinois or Compact license Additional qualities to look for: compact license or multistate licensure
Top 3 must-have hard skills stack-ranked by importance	1	Prior experience with prior auth reviews
2	organized
3	Comfortable on the computer - especially MS Office Suite