Pre-Authorization Supervisor, RN

MotivHealth Insurance Company • South Jordan, UT

3d

About The Position

We are seeking a dedicated and motivated Pre-Authorization Supervisor, RN to join our team. This role will lead and support our pre-authorization team while staying hands-on with clinical reviews, provider communication, and peer-to-peer coordination. This is a great opportunity for an experienced RN who enjoys building processes, collaborating across teams, and making a meaningful impact in a fast-growing organization.

Requirements

• Current, active, and unrestricted Utah RN license
• 5+ years of clinical nursing experience
• 3+ years of pre-authorization, utilization management, or managed care experience
• Prior leadership or team-lead experience
• Comfortable balancing leadership responsibilities with hands-on work
• Strong understanding of medical necessity review and utilization management processes
• Organized, adaptable, and solutions-oriented

Responsibilities

• Supervise and support the Prior Authorization team
• Assign and monitor daily work queues to ensure turnaround time standards are met
• Provide real-time guidance, coaching, and issue resolution
• Assist with onboarding and training of new team members
• Perform and support prior authorization reviews for medical services and procedures
• Apply medical necessity criteria and plan-specific guidelines consistently
• Identify cases requiring escalation and route appropriately to Medical Directors
• Coordinate peer-to-peer reviews between providers and Medical Directors
• Serve as a clinical point of contact for provider inquiries and escalations
• Communicate authorization requirements, documentation needs, and determinations clearly
• Ensure compliance with CMS, state, and federal regulations
• Maintain accurate and complete clinical documentation
• Support audits, quality reviews, and reporting requirements
• Identify workflow issues and recommend process improvements
• Partner with internal teams including Claims, Member Services, Provider Relations, Compliance etc.
• Support new plan implementations and benefit changes

Benefits

• 5% annual bonus based on company profitability
• Affordable health, vision, and dental insurance for you and your family
• Company contributes up to $2,300 to Health Savings Account annually
• Wellness program that contributes additional money towards your HSA
• Automatic 3% contribution into retirement plan
• Career development and growth opportunities
• Flexible Time Off & 10 paid holidays per year

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed