Akido Labs, Inc. is seeking a Clinical Review Nurse to focus on complex case management and prior authorization within a California managed care setting. You will review outpatient requests, analyze medical necessity, and ensure timely determinations in collaboration with Medical Directors and providers.
The role emphasizes adherence to MCG criteria, DMHC/CMS regulations, and EZCap-based documentation, with opportunities to expand into complex case management as the program grows.
#J-18808-LjbffrClinical Review Nurse: Complex Case Mgmt & PA in chino at Unknown Company
This position is listed as full time and onsite.