Prior Authorization Manager
Medcruit →Prior Authorization Manager at Medcruit is a contract role based in Remote · United States-231 (remote). The listing states pay of $105–$105 and asks for 5–15 yrs of experience. Listed skills: Utilization Management. It was published on 13 August 2026 and was open at last check.
| Role | Prior Authorization Manager |
|---|---|
| Company | Medcruit |
| Location | Remote · United States-231 (remote) |
| Employment type | Contract |
| Pay (as listed) | $105–$105 |
| Experience asked | 5–15 yrs |
| Skills listed | Utilization Management |
| Published | 13 August 2026 |
| Status | Open at last check |
Prior Authorization Manager
Hourly Contract
Remote – United States
$105/hour
About the Role
We are seeking experienced Prior Authorization Managers with clinical and medical expertise to evaluate AI tools designed to improve prior authorization workflows.
The role requires strong knowledge of medical necessity criteria, payer requirements, utilization management, and clinical review processes.
Responsibilities
- Manage prior authorization workflows for medical and clinical services across multiple payer types.
- Review clinical documentation against InterQual, MCG, or payer-specific medical necessity criteria.
- Evaluate AI-generated authorization recommendations and clinical justification drafts.
- Coordinate with clinical staff, physicians, and payers to obtain timely approvals.
- Track authorization status, denials, and appeals to identify workflow improvement opportunities.
- Develop and maintain SOPs for authorization submission, follow-up, and escalation.
- Monitor approval rates, turnaround times, and denial rates.
- Ensure compliance with payer requirements, CMS guidelines, and clinical review criteria.
- Provide structured feedback on AI-generated outputs for training datasets.
Requirements
- 5+ years of experience in prior authorization, utilization management, or clinical review, including at least 2 years in a management role.
- Strong clinical knowledge of medical necessity criteria, including InterQual, MCG, or equivalent.
- Experience with commercial, Medicare Advantage, and Medicaid authorization requirements.
- Experience managing authorization workflows across multiple specialties and service types.
- Proficiency with authorization management systems and EHR platforms such as Epic, Cerner, or equivalent.
- Excellent written and verbal English communication skills.
- Strong attention to detail and ability to evaluate clinical documentation and AI-generated content.
Preferred Qualifications
- Clinical licensure (RN, LPN, or equivalent) or CPUR/CPUM certification.
- Experience with appeals and peer-to-peer review processes.
- Familiarity with CMS prior authorization rules and the No Surprises Act.
- Experience in physician office, hospital, or health plan authorization operations.
- Familiarity with AI tools and AI-generated clinical content.
Contract Details
- Type: Hourly Contract
- Location: Remote – United States
- Compensation: $105/hour
- Engagement: Independent contractor
- Schedule: Flexible
- Payment: Weekly
- H1-B/STEM OPT: Not supported
- Projects may be extended, shortened, or concluded early based on needs and performance.
Create a free OnJob profile to apply and see your AI match score before you apply. · Posted 13 Aug 2026.
Prior Authorization Manager at Medcruit — questions answered
What does the Prior Authorization Manager role at Medcruit pay?
The Prior Authorization Manager at Medcruit listing states pay of $105–$105 for the Remote · United States-231 (remote) position. That figure is taken directly from the employer's own posting as published, not estimated or averaged from other roles, and the same listing asks for 5–15 yrs of experience.
Is the Prior Authorization Manager role at Medcruit remote?
Yes — Medcruit advertises this Prior Authorization Manager role as remote, tied to Remote · United States-231, and it is listed as contract work. Remote terms come from the employer's own posting, so confirm the expected working hours, timezone and any on-site days with Medcruit before you apply.
What skills does the Prior Authorization Manager role at Medcruit require?
The Prior Authorization Manager at Medcruit listing names Utilization Management. Those are the skills the employer put on the posting itself, so they are the ones worth matching in your profile and covering first in an interview.
How much experience do you need for the Prior Authorization Manager role at Medcruit?
Medcruit asks for 5–15 yrs of experience on this Prior Authorization Manager posting, alongside Utilization Management. Employers commonly consider candidates slightly under a stated band when the listed skills line up.
Is the Prior Authorization Manager role at Medcruit still open?
The Prior Authorization Manager posting at Medcruit was open at OnJob's last check of the employer's careers page, having been published on 13 August 2026. OnJob re-checks source listings on each build and marks a role closed once it disappears, but listings can close without notice, so the employer's own page is the final word.
How do you apply for the Prior Authorization Manager role at Medcruit?
Apply to the Prior Authorization Manager at Medcruit role through OnJob with a free profile: OnJob scores your fit against the listing, shows the skills lowering that score, and submits an ATS-ready profile. Creating a profile is free and needs no card.
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