Job Title Utilization Review RN Contract Duration 12+ months Job Location 100% REMOTE License Requirements MI Registered Nurse License Mandatory Requirements to Apply • Active, unrestricted Michigan Registered Nurse (RN) license required. • Nursing Diploma or Associate Degree in Nursing required; BSN preferred. • Minimum 5 years of healthcare experience. • 3–5 years of Utilization Management experience required. • Experience with InterQual and/or MCG criteria. • Knowledge of CMS, NCQA, HIPAA, PA60, utilization management, and clinical documentation. • Working knowledge of ICD-10 and CPT coding. Roles & Responsibilities • Deliver clinical education and training for Care Management and Utilization Management staff, including onboarding, mentoring, and ongoing professional development. • Conduct quality reviews, internal and external audits, and analyze performance to support accreditation and continuous quality improvement initiatives. • Develop, maintain, and update training materials, manuals, and educational resources reflecting system updates, InterQual criteria, and departmental processes. • Collaborate with leadership and subject matter experts to implement new programs, systems, and process improvements while supporting change management initiatives. • Coordinate training operations, including scheduling, class administration, new hire system access, attendance tracking, and communication with internal teams and external provider facilities. Salary & Benefits • Pay $35–$39 per hour • Health Insurance (Medical, Dental and Vision) • 9 Days of Paid Time Off • All equipment provided by the client 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