Prior Authorization Associate - Remote US

Date: Feb 4, 2026

Location:

Any city, TX, US, 99999

Req ID: 34445

Work Mode: Virtual (Exception only)

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

The Prior Authorization Associate supports healthcare operations by performing back-office prior authorization (PA) review and decisioning activities. This role is primarily analytical and documentation-focused, applying established policy and program criteria to ensure accurate and timely determinations. While limited provider interaction may occur, this position is not a high-volume inbound call center role.

Your role in our mission

Support state healthcare programs by accurately reviewing and processing prior authorization requests in accordance with established policies and timelines
Help ensure members receive appropriate, timely access to care through consistent and well-documented decisioning
Contribute to the integrity of healthcare operations by maintaining accurate records and adhering to regulatory and compliance standards
Collaborate with internal teams to resolve authorization-related inquiries and improve operational workflows
Uphold Gainwell’s commitment to service excellence, accountability, and quality in delivering critical healthcare support services

What we're looking for

At least 2 years of experience in healthcare operations such as prior authorization, utilization management, claims processing, provider services, or related administrative healthcare roles
Experience interpreting and applying healthcare policies, procedures, or regulatory guidance
Strong written communication skills with the ability to clearly document decisions and outcomes
High attention to detail with the ability to balance accuracy, quality, and productivity
Ability to work independently in a remote environment while collaborating effectively with internal teams

What you should expect in this role

A 100% remote role requiring a reliable high-speed internet connection (minimum 24 Mbps download / 8 Mbps upload)
A back-office, analytical work environment focused on prior authorization review, documentation, and decisioning
Limited phone interaction compared to traditional call center positions
Frequent use of multiple systems to review requests, apply criteria, and document outcomes
A comprehensive Gainwell benefits package including medical, dental, and vision coverage, 401(k) with company match, paid time off, paid holidays, floating holidays, and employee wellness programs

#LI-REMOTE

#LI-JT1

The pay range for this position is $33,500.00 - $47,900.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.