Responsible for the review of precertification admission and concurrent reviews for the appropriateness of the inpatient setting utilizing InterQual criteria. Required to enter or reference data via PC, collaborate with facilities, providers and Medical Directors. Must have excellent written and oral communication skills. Other related skills may be required to perform this job. 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. One (1) year health insurance plan experience or managed care environment preferred. Registered Nurse with current unrestricted Michigan Registered Nurse license required.
Requirements:
Registered Nurse with current Michigan driver's license.
Associate Degree or nursing diploma required.
At least two (2) years patient care experience.
Triage, case management, emergency room or ICU experience or utilization review experience with an insurance company preferred.
Expertise in the use of medical terminology.
InterQual knowledge preferred
Some weekends and corporate holidays.
Work from home position, may require some travel to the office when necessary.
Top 3 Required Skills/Experience -
• 2 years acute care experience with an unrestricted Registered Nurse license
• ICU/ER preferred *should not just be 2 years in a specialized field such as NICU/OB/BH/Substance Abuse *
• InterQual/MCG or other utilization review experience
Required Skills/Experience - The rest of the required skills/experience. Include:
• Advanced computer skills
• 40+ WPM typing
• Good verbal and written communication skills
Preferred Skills/Experience - Optional but preferred skills/experience. Include:
• Utilization Review experience at a previous insurance company (medical, surgical admissions)
• Utilization Review experience in an acute care setting
Education/Certifications - Include:
• Must be a RN with an unrestricted Registered Nurse license
About Kyyba:
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.
Disclaimer:
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 basis covered by appropriate law. Minorities / Females / Protected Veterans /Veteran Spouses/ Individuals with Disabilities are encouraged to apply. All employment is decided on the basis of qualifications, merit, and business need.'
Rewards:
Medical, dental, vision
401k
Term life
Voluntary life and disability insurance
Optional Pre-paid legal plan
Optional Identity theft plan
Optional Medical and dependent FSA
Work-visa sponsorship
Opportunity for advancement
Long-term assignment with opportunity for hire by client
SELECT AWARDS
An INC 5000 company for 10 years
Corp! Michigan Economic Bright Spots
Crain's Detroit Business Top Staffing Service Companies in Detroit
TechServe Alliance Excellence Award- IT and Engineering Staffing & Solutions
Best of MichBusiness winner in HR Wizards & Partnerships
Metro Detroit Elite Category: Recruitment, Selection & Orientation for 101 Best & Brightest
101 Best & Brightest Companies to Work for in Michigan
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