Location: 100% REMOTE Contract Duration: 12+ month [Possible Extension] License Requirements: MI RN License 1. Mandatory Requirements to Apply • Nursing Diploma or Associate Degree required; BSN preferred. • 5+ years in healthcare/health-related fields. • 3–5 years of Care Management and/or Utilization Management experience. • Strong hands-on knowledge of InterQual criteria and utilization management. • Experience with clinical reviews, staff training, quality management, and/or audits. • Knowledge of ICD-10, CPT, CMS, NCQA, PA 60, and HIPAA. • Strong communication, analytical, training, and project management skills. • Proficiency with Microsoft Office, Teams, SharePoint, and healthcare systems. 2. Roles & Responsibilities • Train and educate staff and provider facilities on InterQual criteria, clinical policies, utilization management, and departmental processes. • Conduct clinical quality reviews and audits to support quality and regulatory requirements. • Develop and update InterQual-focused training materials, manuals, and educational programs. • Mentor new employees and work with leadership and subject matter experts to identify training needs. • Support new systems, process improvements, accreditation activities, and quality initiatives. 3. Pay & Benefits • $35–$39/hour • 100% remote – Michigan residents only • 9 days of Paid Time Off • Health Insurance (Dental, Medical and Vision) • All equipment provided by the client Pay: $35.00 - $39.00 per hour Benefits: • Dental insurance • Health insurance • Paid time off • Vision insurance Experience: • Registered Nurse: 6 years (Required) • Utilization Review: 4 years (Required) • InterQual: 3 years (Required) License/Certification: • MI Registered Nurse License (Required) Location: • Michigan (Required) Work Location: Remote
Kyyba Inc. is a staffing/technology services firm recruiting healthcare professionals; this posting is for a remote utilization review RN position restricted to Michigan.
