Job Description

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.

HOW YOU'LL MAKE AN IMPACT:

Team Supervision & Daily Operations

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

Prior Authorization & Clinical Review

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

Provider & Peer-to-Peer Support

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

Quality & Compliance

Ensure compliance with CMS, state, and federal regulations Maintain accurate and complete clinical documentation Support audits, quality reviews, and reporting requirements

Process Improvement & Collaboration

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

WHAT WE'RE LOOKING FOR:

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

HOW WE SUPPORT YOU:

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
MotivHealth is a dynamic and mission-driven health insurance company dedicated to disrupting the status quo by making healthcare simpler and more affordable for our members. We believe in empowering our members to take control of their health and financial well-being. Our innovative approach requires a team of passionate, talented individuals who aren't afraid to challenge conventional thinking and build solutions that truly make a difference. If you're looking to contribute your skills to a company that values innovation and positive impact, MotivHealth is the place for you.

Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Employee discount Health insurance Health savings account Life insurance Paid time off Vision insurance Wellness program
Application Question(s):

Do you have any leadership or team-lead experience?
Experience:

clinical nursing : 5 years (Required) pre-authorization, utilization management, or managed care : 3 years (Required)
License/Certification:

Utah RN License (Required)
Ability to Commute:

South Jordan, UT 84095 (Required)
Work Location: Hybrid remote in South Jordan, UT 84095