Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
McKesson InterQual experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred.
McKesson InterQual experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred.
Conduct case management and utilization management reviews. * Perform 30+ reviews daily using ... Utilize screening criteria such as Cerner, InterQual, and MCG. * Provide excellent patient care ...
Conduct case management and utilization management reviews. * Perform 30+ reviews daily using ... Utilize screening criteria such as Cerner, InterQual, and MCG. * Provide excellent patient care ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Case Mgmt Specialist - BSN
Fort Wayne, IN · On-site
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Preferred experience in Case Management activities ... Preferred experience or knowledge of InterQual criteria. Other Qualifications Demonstrates ...
Director, Case Management
Torrance, CA · On-site
Job Duties: * Provides leadership and management of clinical carecoordination, utilization ... McKesson InterQual experience preferred.
Director, Case Management
Torrance, CA · On-site
Job Duties: * Provides leadership and management of clinical carecoordination, utilization ... McKesson InterQual experience preferred.
Interqual Case Management information
See salary details
$19.23 - $24.76
3% of jobs
$24.76 - $30.29
6% of jobs
$35.30 is the 25th percentile. Wages below this are outliers.
$30.29 - $35.82
17% of jobs
$35.82 - $41.35
20% of jobs
The median wage is $42.45 / hr.
$41.35 - $46.88
16% of jobs
$46.88 - $52.40
11% of jobs
$53.59 is the 75th percentile. Wages above this are outliers.
$52.40 - $57.93
7% of jobs
$57.93 - $63.46
6% of jobs
$63.46 - $68.99
5% of jobs
$68.99 - $74.52
4% of jobs
$74.52 - $80.05
3% of jobs
$19
$47
$80
How much do interqual case management jobs pay per hour?
As of Jun 5, 2026, the average hourly pay for interqual case management in the United States is $47.53, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $57.45 per hour, depending on experience, location, and employer.
What are the key skills and qualifications needed to thrive as an InterQual Case Manager, and why are they important?
To thrive as an InterQual Case Manager, you need a solid background in nursing or healthcare, knowledge of utilization review, and familiarity with case management principles, often supported by RN licensure or similar clinical credentials. Expertise in using InterQual criteria software, electronic health records (EHRs), and utilization management systems is essential. Strong analytical thinking, communication, and collaboration skills help in effectively coordinating patient care and liaising with providers and payers. These skills ensure accurate patient evaluations, compliance with guidelines, and optimal resource utilization within healthcare settings.
What is InterQual Case Management?
InterQual Case Management refers to the use of InterQual criteria, which are evidence-based clinical guidelines, to assess the medical necessity, appropriateness, and level of care for patients within a healthcare setting. Case managers use these tools to ensure patients receive the right care at the right time while meeting insurance and regulatory requirements. This process helps in making decisions about hospital admissions, continued stays, and transitions of care. The goal is to improve patient outcomes and optimize resource utilization.
How does an Interqual Case Manager typically collaborate with healthcare teams to ensure effective patient care transitions?
Interqual Case Managers work closely with physicians, nurses, social workers, and other healthcare professionals to assess patient needs and determine appropriate levels of care using Interqual criteria. Their role often involves facilitating communication between different departments, coordinating discharge planning, and advocating for patient needs. By ensuring that each patient transition meets clinical guidelines, they help reduce readmission rates and support optimal health outcomes. Regular interdisciplinary meetings and thorough documentation are key aspects of their collaborative process.
What is the difference between Interqual Case Management vs Utilization Review Nurse?
| Aspect | Interqual Case Management | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires nursing license, case management certification | Registered Nurse (RN) license, often with utilization review certification |
| Work Environment | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare facilities |
| Primary Focus | Coordinating patient care, discharge planning, case management | Reviewing medical necessity, approving or denying services |
| Usage in Industry | Used for comprehensive case management and care coordination | Primarily involved in utilization review and authorization processes |
Both roles involve nursing expertise and work within healthcare settings, but Interqual Case Management focuses on coordinating patient care and discharge planning, while Utilization Review Nurses primarily evaluate medical necessity for services. Understanding these differences helps healthcare organizations assign the right professionals for each function.
Parkview Health rating
7.1
Based on 268 frontline employees who took The Breakroom Quiz
370th of 865 rated healthcare providers
Job description
Summary
Continuously evaluates the quality, care, treatment and outcomes of complex patient populations. Collaborates with the patient/family and caregivers to facilitate necessary resources and options for post-discharge services to support a safe discharge. Provides consultation with physicians and other members of the interdisciplinary healthcare team to facilitate patient progression to discharge. Ensures clinical documentation supports medical necessity criteria and meets regulatory requirements. Communicates the clinical status of patients related to medical necessity criteria to the physician advisor (internal or external) and/or the Inpatient Care Transitions leadership team as needed. Monitors length of stay and documents avoidable days for delay of discharge. Reviews payer source for potential negative financial liabilities to the patient.
Education
Bachelor of Science in Nursing (BSN) required.
Licensure/Certification
Valid Indiana Registered Nurse license required. Certification in Case Management highly desirable.
Experience
Required at least 2 years of experience in acute care setting. Preferred experience in Case Management activities. Preferred experience or knowledge of InterQual criteria.
Other Qualifications
Demonstrates knowledge of DRGs managed care initiatives, payment methods, and statistical analysis. Demonstrates competency at completion of InterQual training program and ongoing Inter-reliability testing. Demonstrates understanding of managed care concepts. Demonstrates ability to engage in complex clinical decision-making. Demonstrates a strong commitment to interdisciplinary collaboration and communication. Demonstrates critical thinking and analysis and conflict resolution skills. Must have good verbal and written communication skills. Must have excellent people skills and the ability to problem solve efficiently and effectively. Must be available to work flexible hours, including weekends and other times when deemed necessary.
What Parkview Health employees say
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Benefits
Hours and flexibility
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About Parkview Health
Sourced by ZipRecruiter
Parkview Health, headquartered in Fort Wayne, IN, US, operates within the healthcare industry providing a wide range of medical services and community wellness programs. These include primary care, specialty health services, emergency care, rehabilitation, and home health services among others. The non-profit health system was founded in 1878 and continues to serve its surrounding communities with a dedication to quality health and wellness.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Fort Wayne, IN, US
Year founded
1995