• RN - Prior Authorization

    Actalent (Sunrise, FL)
    Actalent is Hiring Multiple Remote HEDIS RN Abstractor Description: Position Purpose: Lead data collection and abstraction for company quality measures, including ... HEDIS, CMS, CHIPRA and/or any other custom measurements. Responsibilities: + Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS… more
    Actalent (05/24/25)
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  • Utilization Review Clinician - Behavioral Health

    Centene Corporation (Tallahassee, FL)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... services to ensure level of care and services are medically appropriate + Performs prior authorization reviews related to mental health and substance abuse to… more
    Centene Corporation (06/01/25)
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