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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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 ...
Troy, MI · Remote
$60K - $60K/yr
Communicate outcomes of UM authorization reviews, both verbally and in writing * Process ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
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Troy, MI · Remote
$60K - $60K/yr
Communicate outcomes of UM authorization reviews, both verbally and in writing * Process ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Troy, MI · Remote
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
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Troy, MI · Remote
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Detroit, MI · On-site +1
$81K - $139K/yr
The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that ... Responsible for participating in field UM program review activities and providing advanced clinical ...
Detroit, MI · On-site +1
$81K - $139K/yr
The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that ... Responsible for participating in field UM program review activities and providing advanced clinical ...
Troy, MI · On-site +1
$60K - $60K/yr
Communicate outcomes of UM authorization reviews, both verbally and in writing * Process ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Troy, MI · On-site +1
$60K - $60K/yr
Communicate outcomes of UM authorization reviews, both verbally and in writing * Process ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Previous experience in quality assurance, utilization review, or clinical leadership * Experience ... Remote work opportunity * Health, dental, and vision insurance * Paid Time Off * Paid holidays ...
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Previous experience in quality assurance, utilization review, or clinical leadership * Experience ... Remote work opportunity * Health, dental, and vision insurance * Paid Time Off * Paid holidays ...
Detroit, MI · On-site +1
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Detroit, MI · On-site +1
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
Detroit, MI · Remote
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Detroit, MI · Remote
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Detroit, MI · Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Evaluate symptoms, review medical histories, and determine appropriate interventions. * Determine ...
Detroit, MI · Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Evaluate symptoms, review medical histories, and determine appropriate interventions. * Determine ...
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Detroit, MI · Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Evaluate symptoms, review medical histories, and determine appropriate interventions. * Determine ...
Detroit, MI · Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Evaluate symptoms, review medical histories, and determine appropriate interventions. * Determine ...
Detroit, MI · Remote
$43 - $56/hr
Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams. Family & Caregiver Collaboration * Provide caregiver training and coaching to ...
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Detroit, MI · Remote
$43 - $56/hr
Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams. Family & Caregiver Collaboration * Provide caregiver training and coaching to ...
... ) to serve our patient population in the navigation, prevention and management of their health ... Welcome patients into continuous care program(s) and review benefits and services included
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... ) to serve our patient population in the navigation, prevention and management of their health ... Welcome patients into continuous care program(s) and review benefits and services included
... ) to serve our patient population in the navigation, prevention and management of their health ... Welcome patients into continuous care program(s) and review benefits and services included
... ) to serve our patient population in the navigation, prevention and management of their health ... Welcome patients into continuous care program(s) and review benefits and services included
Detroit, MI · Remote
$28.85/hr
... in this 100% remote, telephonic role designed for LPNs looking to transition away from bedside ... Provide patient support via incoming patient calls, documentation review support, and special ...
Detroit, MI · Remote
$28.85/hr
... in this 100% remote, telephonic role designed for LPNs looking to transition away from bedside ... Provide patient support via incoming patient calls, documentation review support, and special ...
Detroit, MI · Remote
$60K/yr
... in this 100% remote, telephonic role designed for LPNs looking to transition away from bedside ... Provide patient support via incoming patient calls, documentation review support, and special ...
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Detroit, MI · Remote
$60K/yr
... in this 100% remote, telephonic role designed for LPNs looking to transition away from bedside ... Provide patient support via incoming patient calls, documentation review support, and special ...
$19.69 - $23.68
2% of jobs
$23.68 - $27.66
9% of jobs
$30.38 is the 25th percentile. Wages below this are outliers.
$27.66 - $31.64
21% of jobs
The median wage is $34.86 / hr.
$31.64 - $35.62
23% of jobs
$35.62 - $39.61
13% of jobs
$42.70 is the 75th percentile. Wages above this are outliers.
$39.61 - $43.59
10% of jobs
$43.59 - $47.57
8% of jobs
$47.57 - $51.55
5% of jobs
$51.55 - $55.54
5% of jobs
$55.54 - $59.52
2% of jobs
$59.52 - $63.50
2% of jobs
$19
$38
$63
As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.
| Aspect | Remote Utilization Review Nurse | Remote Case Manager |
|---|---|---|
| Certifications | RN license, possibly CCM or UR certifications | RN license, CCM or case management certifications |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Insurance companies, healthcare organizations, telehealth |
| Job Focus | Review medical necessity, approve or deny services | Coordinate patient care, arrange services, discharge planning |
Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.
The most popular types of Utilization Review Nurse jobs in Rochester Hills, MI are:
For Remote Utilization Review Nurse jobs in Rochester Hills, MI, the most frequently searched job titles are:
The top searched job categories for Remote Utilization Review Nurse jobs in Rochester Hills, MI are:
Cities near Rochester Hills, MI with the most Remote Utilization Review Nurse job openings:
$35 - $39/hr
Contractor
Medical, Dental, Vision, PTO
Posted 15 days ago
Job Title: Utilization Review RN
Contract Duration: 12+ months
Job Location: 100% REMOTE
License Requirements: MI Registered Nurse License
Mandatory Requirements to Apply
Roles & Responsibilities
Salary & Benefits
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
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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.
Recruiting and staffing services
501 - 1,000 Employees
Farmington Hills, MI, US
1998
