US - California - Burbank
June 15, 2024
Manager of Clinical Utilization Management - Denial Compliance
Location: Burbank, CA
Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA); Full-Time Salaried Position
Company: Vivo HealthStaff Inc.
Overview:
Vivo HealthStaff is recruiting for a dedicated Manager of Clinical Utilization Management - Denial Compliance. This role is pivotal in ensuring a streamlined and compliant denial process, in line with regulatory, accreditation, and health plan standards.
Key Responsibilities:
1. Oversee both licensed and non-licensed denial unit staff, managing daily tasks, performance reviews, and any necessary disciplinary actions.
2. Foster effective communication and collaboration with physician reviewers, medical directors, and other relevant departments.
3. Ensure timely responses to requests and maintain high standards of compliance and privacy.
4. Assist in the preparation of various reports, including departmental work-plans and audits.
5. Monitor and enhance the quality of the denial process internally.
6. Design and deliver training sessions for the denial unit staff to ensure top-notch, compliant communication.
7. Stay updated with state and federal regulations related to the department and implement necessary changes.
8. Lead the department towards achieving set objectives and provide guidance to team members.
9. Implement procedures to ensure alignment with company policies and influence process improvements.
10. Handle other duties as directed by the management.
Qualifications:
1. Graduate from an accredited Registered Nursing Program; RN preferred.
2. Minimum of five years in prior-authorization, appeals & grievance, or health plan compliance.
3. Proven experience in project development, staff supervision, and performance monitoring.
4. Strong communication skills, both verbal and written.
5. Ability to manage multiple projects in a high-stress environment and adapt to changing priorities.
6. Proficiency in MS Office and a computerized environment.
7. Valid CA driver's license and car insurance.
Policies:
1. Uphold honesty and integrity.
2. Adhere to privacy, compliance policies, and the corporate code of conduct.
3. Lead and participate in team meetings and promote organizational goals.
4. Provide top-tier customer service and be adaptable to flexible work hours.
Benefits:
United States - CA - CA - Santa Monica
June 13, 2024
Access Healthcare is seeking a travel CT Technologist for a travel job in Santa Monica, California. & Requirements • Specialty: CT Technologist • Discipline: Allied Health Professional • Start Date: 07/08/2024 • Duration: 13 weeks • 40 hours per week • Shift: 10 hours, nights • Employment Type:...
United States - CA - CA - Los Angeles
June 13, 2024
Access Healthcare is seeking a travel CT Technologist for a travel job in Los Angeles, California. & Requirements • Specialty: CT Technologist • Discipline: Allied Health Professional • Start Date: 07/08/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel...
United States - CA - CA - Jurupa Valley
June 13, 2024
C.R. England is Now Hiring Experienced CDL-A Truck Drivers • Drivers Earn $57,000-$79,000 Yearly* - No-Touch Freight • Valid CDL-A and 3+ months of current experience required. • This lane is not suitable for students, recent grads, or trainees. WHY DRIVE WITH C.R. ENGLAND? • Home weekly, 34-hour...
United States - CA - CA - Santa Rosa
June 13, 2024
Vivian is looking for Travel Radiology Technologist Allied Health Professionals in Santa Rosa, California paying up to $2,447/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: •...
United States - CA - CA - Riverside
June 13, 2024
C.R. England is Now Hiring Experienced CDL-A Truck Drivers • Drivers Earn $57,000-$79,000 Yearly* - No-Touch Freight • Valid CDL-A and 3+ months of current experience required. • This lane is not suitable for students, recent grads, or trainees. WHY DRIVE WITH C.R. ENGLAND? • Home weekly, 34-hour...
United States - CA - CA - Riverside
June 13, 2024
U.S. Xpress is now hiring CDL-A OTR Team Drivers • CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/Split! Your team can average $200,000 or more! Don t have a team partner? We will help you find the right partner with our TEAM match program! Or make your own team! Now's the...
United States - CA - CA - Jurupa Valley
June 13, 2024
U.S. Xpress is now hiring CDL-A OTR Team Drivers • CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/Split! Your team can average $200,000 or more! Don t have a team partner? We will help you find the right partner with our TEAM match program! Or make your own team! Now's the...
United States - CA - CA - Walnut Creek
June 13, 2024
Access Healthcare is seeking a travel nurse RN Maternal - Newborn for a travel nursing job in Walnut Creek, California. & Requirements • Specialty: Maternal - Newborn • Discipline: RN • Start Date: ASAP • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment Type: Travel...
United States - CA - CA - Pacoima
June 13, 2024
U.S. Xpress is now hiring CDL-A OTR Team Drivers • CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/Split! Your team can average $200,000 or more! Don t have a team partner? We will help you find the right partner with our TEAM match program! Or make your own team! Now's the...
United States - CA - CA - Sylmar
June 13, 2024
C.R. England is Now Hiring Experienced CDL-A Truck Drivers • Drivers Earn $57,000-$79,000 Yearly* - No-Touch Freight • Valid CDL-A and 3+ months of current experience required. • This lane is not suitable for students, recent grads, or trainees. WHY DRIVE WITH C.R. ENGLAND? • Home weekly, 34-hour...
United States - CA - CA - Burlingame
June 13, 2024
Access Healthcare is seeking a travel Cardiac Sonographer for a travel job in Burlingame, California. & Requirements • Specialty: Cardiac Sonographer • Discipline: Allied Health Professional • Start Date: 07/15/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type:...
United States - CA - CA - Lakeport
June 13, 2024
Access Healthcare is seeking a travel CT Technologist for a travel job in Lakeport, California. & Requirements • Specialty: CT Technologist • Discipline: Allied Health Professional • Start Date: 07/15/2024 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, days • Employment Type: Travel...
United States - CA - CA - Antioch
June 13, 2024
Vivian is looking for Travel MICU - Medical Intensive Care Unit RNs in Antioch, California paying up to $2,765/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile...
United States - CA - CA - Crescent City
June 13, 2024
Vivian is looking for Travel Home Health RNs in Crescent City, California paying up to $2,352/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build your...
United States - CA - CA - Reseda
June 13, 2024
U.S. Xpress is now hiring CDL-A OTR Team Drivers • CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/Split! Your team can average $200,000 or more! Don t have a team partner? We will help you find the right partner with our TEAM match program! Or make your own team! Now's the...
United States - CA - CA - Panorama City
June 13, 2024
U.S. Xpress is now hiring CDL-A OTR Team Drivers • CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/Split! Your team can average $200,000 or more! Don t have a team partner? We will help you find the right partner with our TEAM match program! Or make your own team! Now's the...
United States - CA - CA - Laguna Hills
June 13, 2024
Vivian is looking for Travel ICU - Intensive Care Unit RNs in Laguna Hills, California paying up to $2,116/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile -...
United States - CA - CA - Reseda
June 13, 2024
C.R. England is Now Hiring Experienced CDL-A Truck Drivers • Drivers Earn $57,000-$79,000 Yearly* - No-Touch Freight • Valid CDL-A and 3+ months of current experience required. • This lane is not suitable for students, recent grads, or trainees. WHY DRIVE WITH C.R. ENGLAND? • Home weekly, 34-hour...
United States - CA - CA - Sylmar
June 13, 2024
U.S. Xpress is now hiring CDL-A OTR Team Drivers • CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/Split! Your team can average $200,000 or more! Don t have a team partner? We will help you find the right partner with our TEAM match program! Or make your own team! Now's the...
United States - CA - CA - Crescent City
June 13, 2024
Access Healthcare is seeking a travel nurse RN Rehabilitation for a travel nursing job in Crescent City, California. & Requirements • Specialty: Rehabilitation • Discipline: RN • Start Date: 07/15/2024 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment Type: Travel...
United States - CA - CA - Walnut Creek
June 13, 2024
Access Healthcare is seeking a travel CT Technologist for a travel job in Walnut Creek, California. & Requirements • Specialty: CT Technologist • Discipline: Allied Health Professional • Start Date: ASAP • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment Type: Travel...
United States - CA - CA - Oakland
June 13, 2024
Access Healthcare is seeking a travel Mammography Technologist for a travel job in Oakland, California. & Requirements • Specialty: Mammography Technologist • Discipline: Allied Health Professional • Start Date: 07/08/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment...
United States - CA - CA - Castro Valley
June 13, 2024
Vivian is looking for Travel Clinical Nurse Coordinator RNs in Castro Valley, California paying up to $3,358/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile -...
United States - CA - CA - Corona
June 13, 2024
U.S. Xpress is now hiring CDL-A OTR Team Drivers • CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/Split! Your team can average $200,000 or more! Don t have a team partner? We will help you find the right partner with our TEAM match program! Or make your own team! Now's the...
United States - CA - CA - Pacoima
June 13, 2024
C.R. England is Now Hiring Experienced CDL-A Truck Drivers • Drivers Earn $57,000-$79,000 Yearly* - No-Touch Freight • Valid CDL-A and 3+ months of current experience required. • This lane is not suitable for students, recent grads, or trainees. WHY DRIVE WITH C.R. ENGLAND? • Home weekly, 34-hour...
United States - CA - CA - Orange
June 13, 2024
Access Healthcare is seeking a per diem / prn nurse RN ICU - Intensive Care Unit for a per diem / prn nursing job in Orange, California. & Requirements • Specialty: ICU - Intensive Care Unit • Discipline: RN • Start Date: 07/15/2024 • Duration: Ongoing • Up to 36.00 hours per week • Shift: 12 hours,...
United States - CA - CA - Burlingame
June 13, 2024
Access Healthcare is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Burlingame, California. & Requirements • Specialty: OR - Operating Room • Discipline: RN • Start Date: 07/15/2024 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel...