Clinical Utilization Management Specialist

3 weeks ago


Burbank, California, United States Vivo HealthStaff Full time
Job Description

The Clinical Utilization Management Specialist role at Vivo HealthStaff is pivotal in ensuring a streamlined and compliant denial process. As a key member of the team, you will oversee daily tasks, performance reviews, and disciplinary actions for licensed and non-licensed staff. This position requires strong communication and collaboration skills, as well as the ability to manage multiple projects in a high-stress environment.

We offer a competitive salary of $95,000 - $110,000 per year, depending on experience. Our comprehensive benefits package includes healthcare coverage and a 401k plan.

Key Responsibilities:
  • Oversee daily tasks and performance reviews for licensed and non-licensed staff
  • Foster effective communication and collaboration with physician reviewers, medical directors, and other departments
  • Ensure timely responses to requests and maintain high standards of compliance and privacy
  • Assist in the preparation of reports, including departmental work-plans and audits
Requirements:
  • Graduate from an accredited Registered Nursing Program; RN preferred
  • Minimum of five years in prior-authorization, appeals & grievance, or health plan compliance
  • Proven experience in project development, staff supervision, and performance monitoring
  • Strong communication skills, both verbal and written


  • Burbank, California, United States Professional Case Management Full time

    OverviewAt Professional Case Management, we are committed to providing exceptional in-home care services to clients who have suffered from chronic illnesses due to exposure to toxic substances while working for the government. As a Clinical Nurse Specialist - In-Home Care, you will play a critical role in ensuring the delivery of high-quality patient care...


  • Burbank, California, United States Professional Case Management Full time

    Job Description:We are seeking a highly skilled and compassionate Clinical Case Manager to join our team at Professional Case Management. As a key member of our healthcare team, you will provide exceptional care and support to our clients who are former Nuclear Weapon Workers suffering from chronic or terminal illnesses.Responsibilities:Provide in-home...


  • Burbank, California, United States IVIRMA Global Full time

    About the RoleWe are seeking a dedicated Clinical Nurse Specialist to join our team at IVIRMA Global, a world-renowned leader in fertility care. As a key member of our patient care team, you will provide exceptional nursing services to our patients, guiding them through their fertility journey with empathy and expertise.Job DescriptionCoordinate care...


  • Burbank, California, United States Professional Case Management Full time

    Senior Case Manager RNProfessional Case Management seeks a highly skilled Senior Case Manager RN to lead our team of RN case managers. As a Senior Case Manager RN, you will provide direct care and case management to clients while overseeing the provision of care in accordance with Agency policy and state-specific nurse practice act.About the JobDirectly...


  • Burbank, California, United States Martin Luther King, Jr. Community Hospital Full time

    **About Us**Martin Luther King, Jr. Community Hospital is a leading healthcare provider in the community.**Job Summary**The Clinical Staff Nurse Specialist provides high-quality patient care and manages patient flow in the Emergency Department.**Responsibilities**Assess patients' needs and develop individualized care plansProvide direct patient care,...


  • Burbank, California, United States Providence Saint Joseph Medical Center Full time

    The Providence Saint Joseph Medical Center is seeking a skilled Clinical Cardiology Specialist to join its team. This role offers a weekly salary of $3,084 and requires a California state license, ACLS certification, and BLS certification.Job RequirementsA minimum of one year of experience in cath lab technology is required for this position.Candidates must...


  • Burbank, California, United States Aerotek Full time

    Role OverviewAerotek is currently seeking an experienced Underground Utility Construction Foreman to manage and oversee the installation and maintenance of underground utilities. This Contract-to-Hire position offers an exciting opportunity to work on a variety of projects while developing your skills and expertise.Key ResponsibilitiesSupervise and manage...


  • Burbank, California, United States Inogen Full time

    Job OverviewThe Clinical Support Specialist is a vital role within Inogen, responsible for ensuring the smooth delivery and setup of medical equipment to patients in their homes. This part-time position requires strong communication skills, attention to detail, and the ability to work independently.


  • Burbank, California, United States Martin Luther King, Jr. Community Hospital Full time

    Job Summary">This role involves collaboration with multidisciplinary teams, effective communication, and adherence to nursing standards to ensure positive patient outcomes. The nurse plays a key role in patient education, comfort, and safety while managing various clinical situations under the supervision of the Clinical Unit...

  • Clinical Nurse

    2 days ago


    Burbank, California, United States Martin Luther King, Jr. Community Hospital Full time

    Job Summary:Rn Clinical Staff Med/Surg/Tele 3rd floor Full Time - Nights at Martin Luther King, Jr. Community Hospital summary:The RN Clinical Staff Nurse at Martin Luther King, Jr. Community Hospital is responsible for managing patient care and delivering high-quality nursing services on a Med/Surg/Telemetry unit. This role includes utilizing nursing...


  • Burbank, California, United States Aerotek Full time

    About the RoleAs a seasoned Underground Utility Construction Foreman, you will play a pivotal role in overseeing the installation and maintenance of underground utilities such as water, sewer, gas, and electrical lines. Your responsibilities will include project management, crew supervision, safety compliance, quality control, coordination, problem-solving,...


  • Burbank, California, United States Vivo HealthStaff Full time

    Job OverviewWe are seeking a highly skilled Clinical Compliance Specialist to join our team at Vivo HealthStaff. As a key member of our healthcare operations team, you will be responsible for ensuring a high-quality, efficient, and compliant denial process, adhering to all regulatory, accreditation, and health plan standards for associated medical...

  • Clinical Specialist

    4 days ago


    Burbank, California, United States Los Angeles Cancer Network Full time

    Our organization, OneOncology, is a national partnership of leading independent community oncology practices. We are dedicated to providing unparalleled care to patients with blood disorders and cancer. As a Clinical Specialist, you will play a crucial role in our mission.We are seeking an experienced Nurse Practitioner or Physician Assistant to join our...


  • Burbank, California, United States Los Angeles Cancer Network Full time

    Career Opportunity: We are seeking a highly skilled and dedicated Clinical Care Specialist to join our team at Los Angeles Cancer Network. As a Clinical Care Specialist, you will have the opportunity to make a real difference in the lives of our patients by providing exceptional care and support throughout their cancer journey.About the Role: This is a...


  • Burbank, California, United States Rowan Center for Behavioral Medicin Full time

    At Rowan Center for Behavioral Medicine, we are committed to providing exceptional mental health care to our patients. As a Clinical Mental Health Specialist, you will play a vital role in our multidisciplinary team, working closely with other healthcare professionals to deliver comprehensive care.We are seeking a highly skilled and experienced Clinical...


  • Burbank, California, United States Provider Solutions & Development Full time

    We are seeking a skilled Clinical Hematology Specialist to join our esteemed team at Providence Medical Institute in Burbank, California.About the RoleThis is a full-time position with a Monday to Friday schedule and no call or weekend requirements.ResponsibilitiesProvide exceptional patient care as a member of our multidisciplinary team.Collaborate with...


  • Burbank, California, United States Alpha Management Company Full time

    Job DescriptionWe are seeking an experienced Leasing Specialist to join our team at Alpha Management Company. In this role, you will be responsible for managing the waiting list, processing move-ins and move-outs, and creating reports on vacancies and collections.Job Duties:Review waiting list reports, ensuring up-to-date information and timely follow-ups...


  • Burbank, California, United States TotalMed Case Management Staffing Full time

    Job Title: Travel Nurse SpecialistAbout the Job:TotalMed Case Management Staffing is seeking a highly skilled travel nurse specialist to join their team. The ideal candidate will have experience in case management and possess excellent communication skills.The job involves working as a Registered Nurse (RN) on a 13-week contract, with a start date of...

  • EMT Specialist

    2 days ago


    Burbank, California, United States AMR Full time

    Job OverviewWe are seeking highly skilled and compassionate EMT Specialists to join our team as Critical Care Transport Paramedics. As a member of our team, you will be responsible for responding to emergent and non-emergent medical requests, delivering high-quality patient care and treatment in accordance with established protocols.About the RoleYou will...


  • Burbank, California, United States AMR Full time

    Job Summary:The Medical Professional - Critical Care Specialist provides emergency and non-emergency medical assistance, ensuring high-quality patient care according to clinical protocols and established policies.Responsibilities include assessing call situations, utilizing medical equipment for advanced care, and communicating effectively with patients and...