RN - Utilization Review Analyst

Job Description

Duration: 6 months

Will this position be required to work onsite for any reason at any time? Yes

Engagement Description –

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through the health care continuum including member outreach assessments.

Top 3 Required Skills/Experience –

• Bachelor's degree in nursing, allied health, business, or related field preferred.

• Two (2) to four (4) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc. Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.

• Registered Nurse with current unrestricted Michigan Registered Nurse license required.

Required Skills/Experience – The rest of the required skills/experience. Include:

• Above average computer skills (Microsoft office).

• Clinical experience in ICU, ER, or medical surgical unit preferred.

• Resource will be able to perform this role offsite. May be required to come into the office for meetings and training.

Preferred Skills/Experience – Optional but preferred skills/experience. Include:

• One (1) year health insurance plan experience or managed care environment preferred.

• Certification in Case Management may be preferred based upon designated department assignment.

Education/Certifications – Include:

• Bachelor's degree in nursing, allied health, business, or related field preferred.

• Registered Nurse with current unrestricted Michigan Registered Nurse license required.

• One (1) year health insurance plan experience or managed care environment preferred.

• Certification in Case Management may be preferred based upon designated department assignment.Company Description

Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.

At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.

Kyyba is an Equal Opportunity Employer.

Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b

Full-time

Hybrid remote