Registered Nurse II – Prior Authorization & Referral

About the role

University Health Services at Texas A&M University seeks a Registered Nurse II to manage prior authorizations and external specialty referrals. The role ensures timely, continuous care for students by navigating payer policies, coordinating documentation, and supporting clinic operations.

Key responsibilities

• Review and process prior authorizations for medications, radiology, and specialty services, adhering to payer step‑therapy and quantity limits.
• Coordinate external referrals, ensuring complete documentation and follow‑up with specialty providers.
• Facilitate peer‑to‑peer reviews with payers to resolve denials and assist patients in accessing financial assistance programs.
• Supervise nursing support staff, manage scheduling, approve timesheets, and provide coaching.

Required profile

• Associate Degree in Nursing (ADN) and active Texas RN license.
• Minimum two years of RN experience, preferably in prior authorizations, care coordination, or outpatient clinic settings.
• CPR certification.

Required skills

• Proficiency with electronic medical record (EMR) systems.
• Ability to navigate payer portals and referral platforms independently.

What we offer

• Comprehensive health benefits including medical, dental, vision, and prescription coverage.
• Paid holidays, sick leave, and vacation time.
• Retirement plan through the Teacher Retirement System of Texas.
• Professional development resources such as LinkedIn Learning and tuition assistance.