KYYBA Inc · 5 days ago
RN Review Analyst
Grand Rapids, MI
Full-time
Hybrid
Mid Level
3+ years expKYYBA Inc is seeking a Registered Nurse for the RN Review Analyst position, primarily involving remote work with some onsite requirements in the Grand Rapids area. The role focuses on conducting medical record reviews, provider education, and in-home screenings while building professional relationships with healthcare providers.
AutomotiveConsultingStaffing Agency
Responsibilities
Provide comprehensive research and responses for identified problems and complex inquiries related to the provider community
Conduct activities as assigned such as in-home Bone Mineral Density (BMD) testing on members
Conduct in-state provider educational sessions in person and virtually on relevant topics such as new business tools, billing/coding, Health e-Blue (HeB), HEDIS, medical record reviews, etc
Perform clinical reviews with knowledge of clinical documentation, body systems, anatomy and physiology, preventative screening, etc. Scan records as required
Develop and maintain an effective, professional working relationship with providers and their staff
Support providers in closing treatment opportunities (HEDIS/Star measures)
Assist leaders in monitoring issues, projects, timelines, and plans related to various corporate initiatives impacting providers
Research, analyze, identify, and evaluate data to assess existing trends and issues
Recommend, communicate, and implement solutions to identified problems and root cause of issues
Represent and participate in group discussions
Assist other departments / consultants when visiting providers to discuss a variety of HEDIS/Star related topics
Generate summary of activity monthly and as requested
Qualification
Required
Current unrestricted state of Michigan registered nurse license required
Knowledge of quality improvement / process improvement / clinical guidelines
Experience with MS Office skills. Excel is a plus
Valid MI driver's license; willing to drive to provider locations and travel throughout Michigan as needed (no exceptions)
Have a dependable vehicle every workday and be willing to travel up to five days a week (varies dependent on time of year, however, travel tends to average mostly 1-3 days per week)
Minimum three years of clinical experience
Preferred
Knowledgeable of NCQA HEDIS medical record review
Bachelor's degree in nursing
Strong knowledge and experience in use of software (e.g., Excel, Outlook, PowerPoint, Word, etc.)
Effective communication skills, written and verbal
Experience in provider consulting/relations
Strong analytical, organizational, planning, and problem-solving skills
Ability to effectively interface with employees at all levels
Ability to understand and apply statistical inference including research principles
Demonstrated medical and clinical knowledge required to analyze related issues and apply principles to health care business environment
Benefits
Mileage Reimbursement: Total miles - normal commuter miles = reimbursement
Company
KYYBA Inc
Kyyba, Inc.
1001-5000 employees
H1B Sponsorship
KYYBA Inc has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (55)
2024 (85)
2023 (79)
2022 (95)
2021 (78)
2020 (71)
Funding
Current Stage
Late StageLeadership Team
Thiru Ganesan
President & CEO
Tel Ganesan
Founder & Executive Chairman
Recent News
Company data provided by crunchbase