About this opportunity
Akido Companies Internal Job Board lists this Clinical Review Nurse — Complex Care & Prior Authorization opportunity in chino, California. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Akido Companies is seeking a Clinical Review Nurse to join our Utilization Management team in California. You will review and process prior authorizations for outpatient services, diagnostic testing, and DME, ensuring medical necessity and compliance with health plan guidelines.
Responsibilities include case management support for high-risk members, documentation in EZCap, collaboration with Medical Directors, and maintaining turnaround times under DMHC and CMS requirements.
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Worksite address
chino, CA, 91708, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.