New

Clinical Review Nurse - Prior Authorization

Spectraforce Technologies

United States, Texas, Houston

Feb 17, 2026

Position Title: Clinical Review Nurse - Prior Authorization

Work Location: Remote - Texas

Assignment Duration: 03 Months Possibility to extend or convert

Work Schedule:

Schedule may vary: Training will be 8am-5pm Monday through Friday. Once training is completed, the scheduled will either be Tuesday- Saturday- 10a-7pm Tuesday -Saturday or Sunday- Thursday 10a-7pm. Manager will review schedules in the interview as well.

Work Arrangement: Remote

Position Summary:

Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage.

Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.

Key Responsibilities:

* Filtering assignments, processing prior authorizations for Texas Ambetter to maintain compliance and turn around time.

Candidate Requirements
Required: Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related experience.	Preferred: BSN preferred, ADN accepted
Required: RN License	Preferred:
Years of experience required: 2-4 years prior authorization experience from the insurance side. Disqualifiers: Additional qualities to look for: Knowledge with TruCare and/or Interqual (IQ)
Top 3 must-have hard skills stack-ranked by importance	1	Proficiently navigating all required programs, systems, and computer applications
2	The ability to work efficiently and accurately in a fast?paced environment
3	Being a team player who can adapt well to change