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Director Remote Utilization Review Jobs in Detroit, MI

KYYBA

Remote Utilization Review RN

Detroit, MI · Remote

$35 - $39/hr

Utilization Review RN Contract Duration: 12+ months Job Location: 100% REMOTE License Requirements: MI Registered Nurse License Mandatory Requirements to Apply * Active, unrestricted Michigan ...

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All JobsUtilization Review JobsDirector Remote Utilization Review JobsDirector Remote Utilization Review Jobs in Detroit, MI

Director Remote Utilization Review information

See Detroit, MI salary details

$21

$41

$68

How much do director remote utilization review jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for director remote utilization review in Detroit, MI is $41.86, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.08 per hour, depending on experience, location, and employer.

What is a director of remote utilization review?

A Director of Remote Utilization Review is a healthcare leader responsible for overseeing teams that assess the necessity, appropriateness, and efficiency of medical services, typically from a remote or virtual environment. This role ensures compliance with regulatory guidelines, optimizes resource use, and helps manage healthcare costs while maintaining quality patient care. Directors collaborate with physicians, nurses, and insurance providers to review clinical cases and develop utilization review strategies. They also monitor performance metrics and implement process improvements for remote teams.

How does a director of remote utilization review typically collaborate with clinical and administrative teams to ensure effective patient care management?

A Director of Remote Utilization Review plays a pivotal role in bridging clinical staff, case managers, and administrative teams to optimize patient care and resource utilization. This is often achieved through regular virtual meetings, data sharing, and cross-departmental strategy sessions to review utilization trends and address barriers to care. The director ensures that remote teams adhere to regulatory standards and organizational goals, fostering open communication to streamline workflows and resolve complex cases efficiently. Successful collaboration enhances patient outcomes, reduces unnecessary costs, and maintains compliance, all while supporting a positive remote team environment.

What are the key skills and qualifications needed to thrive as a director of remote utilization review, and why are they important?

To thrive as a Director of Remote Utilization Review, you need in-depth knowledge of healthcare regulations, utilization management processes, and a relevant clinical background, typically supported by an RN or other clinical licensure and experience in case management. Familiarity with utilization review software, electronic health records (EHR), and certifications such as CCM or UM are often required. Leadership, analytical thinking, and strong communication skills are vital for guiding teams and collaborating with stakeholders. These skills ensure effective oversight of remote teams, regulatory compliance, and optimal patient care outcomes.

What is the difference between Director Remote Utilization Review vs Utilization Review Nurse?

AspectDirector Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, advanced degree, and management experienceRegistered Nurse (RN) license, relevant clinical experience
Work EnvironmentOversees teams remotely, strategic planning, policy developmentConducts patient reviews, collaborates with healthcare providers, often remote or onsite
Employer & Industry UsageHealth insurance companies, managed care organizationsHospitals, insurance companies, healthcare facilities

The main difference is that the Director Remote Utilization Review focuses on managing teams and policies remotely, while the Utilization Review Nurse performs clinical reviews directly related to patient care. The director has a broader strategic role, whereas the nurse role is more clinical and operational.

What are the most commonly searched types of Remote Utilization Review jobs in Detroit, MI?

The most popular types of Remote Utilization Review jobs in Detroit, MI are:

What cities near Detroit, MI are hiring for Director Remote Utilization Review jobs?

Cities near Detroit, MI with the most Director Remote Utilization Review job openings:

Director Remote Utilization Review jobs near you
Infographic showing various Director Remote Utilization Review job openings in Detroit, MI as of August 2026, with employment types broken down into 79% Full Time, 7% Part Time, and 14% Contract. Highlights an 79% In-person, 7% Hybrid, and 14% Remote job distribution, with an average salary of $87,064 per year, or $41.9 per hour.

Remote Utilization Review RN

KYYBA

Detroit, MI • Remote

$35 - $39/hr

Contractor

Medical, Dental, Vision, PTO

Posted 24 days ago

Job description

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

KYYBA logo

About KYYBA

Sourced by ZipRecruiter

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.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Farmington Hills, MI, US

Year founded

1998

Social media

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