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Prior Authorization Utilization Review Nurse

Gainwell Technologies · Prior Authorization Specialist · Utilization Review · Remote
RemoteFull-timeNo bedside careRemote
Posted 9/22/2026
Role summary

A fully remote role dedicated to reviewing prior authorization requests and evaluating medical necessity. The nurse will work closely with healthcare providers to facilitate clinical decisions.

Work this role from any clinic, anywhere in the country — as long as your license, certifications and ID documents are current and valid for the employer's required state(s).

Assess clinical information against medical policy and criteria for prior authorization requests. Facilitate communication between providers and the utilization management team to resolve clinical inquiries. Maintain up-to-date knowledge of clinical guidelines and healthcare regulations.

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