Registered Nurse II - Prior Authorization and Referral

Location: College Station, Texas, United States; onsite

Company

University Health Services provides integrated physical and mental healthcare supporting Texas A&M University students.

What you will do

• Review and process prior authorizations for medications, radiology procedures, and specialty services.
• Navigate payer policies, gather clinical documentation, track authorization status, and address denials through peer-to-peer reviews.
• Coordinate external specialty referrals, documentation, communications, and follow-up to support continuity of care.
• Educate patients and staff about referral processes, coverage details, treatment plans, and related workflows.
• Supervise designated nursing or medical support staff, including workload distribution, scheduling, coverage, timesheets, and performance feedback.
• Support clinic operations, staff onboarding, regulatory compliance, and workflow and quality improvement initiatives.

Requirements

• Associate Degree in Nursing.
• Two years of experience as a Registered Nurse.
• Active Registered Nurse license issued by the State of Texas.
• CPR certification.
• Knowledge of nursing procedures, insurance guidelines, prior authorization processes, clinical documentation, and electronic medical records.
• Strong organizational, communication, problem-solving, confidentiality, and multitasking skills.

Nice to have

• Bachelor's degree in Nursing.
• Recent experience in prior authorization, utilization management, care coordination, case management, payer policy navigation, referral processing, or ambulatory care.
• Experience supervising employees, conducting performance evaluations, staffing, or scheduling.

Culture & Benefits

• Medical, prescription, dental, vision, life, accidental death and dismemberment, flexible spending, and long-term disability insurance.
• Paid holidays, monthly paid sick leave, and paid vacation.
• Automatic enrollment in the Teacher Retirement System of Texas.
• Free exercise programs, wellness resources, LinkedIn Learning, professional development support, educational release time, and tuition assistance.
• FERPA and HIPAA training is required upon employment and on a recurring basis.