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Interqual Jobs in Colorado (NOW HIRING)

Astyra Corporation

Clinical Reviewer

Denver, CO

$35 - $40/hr

Conduct medical record reviews using InterQual, MCG, or similar criteria to determine medical necessity. * Perform utilization management across DME, acute care, inpatient services, imaging, genetic ...

Mission Hospital

RN Case Manager Weekend Plan

Aurora, CO · On-site

$40.35 - $58.87/hr

... InterQual) throughout the episode of care; escalates progression and transition of care issues through the established chain of command. • Makes appropriate referrals to third party payer and ...

Menorah Medical Center

RN Case Manager PRN

Denver, CO · On-site

Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established ...

Research Medical Center

RN Case Manager PRN

Denver, CO · On-site

Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established ...

Mission Hospital

RN Case Manager PRN

Denver, CO · On-site

$40.35 - $58.87/hr

Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established ...

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Interqual information

See Colorado salary details

$41K

$94.1K

$171.4K

How much do interqual jobs pay per year?

As of Aug 8, 2026, the average yearly pay for interqual in Colorado is $94,093.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,800.00 and $109,900.00 per year, depending on experience, location, and employer.

What does someone working with InterQual do?

Professionals utilizing InterQual criteria are primarily responsible for reviewing medical records and assessing whether inpatient admissions, procedures, or continued stays meet established clinical guidelines. Daily tasks often include documenting findings, communicating with physicians and care teams to clarify case details, and collaborating with insurance companies regarding authorization of services. These professionals act as a key resource for ensuring compliance with industry standards and optimizing patient care pathways. Successful InterQual specialists proactively identify discrepancies and help resolve issues that might delay care or reimbursement. You can expect regular interaction with both clinical and administrative staff in a fast-paced healthcare environment.

What are the key skills and qualifications needed to thrive in the InterQual position?

To excel in a role focused on InterQual, such as an InterQual Specialist or Utilization Review Nurse, you need a strong background in healthcare, clinical assessment skills, and familiarity with utilization management. Proficiency in using InterQual software, electronic health records (EHRs), and knowledge of medical necessity criteria are essential, and certification in case management or utilization review is often preferred. Attention to detail, strong analytical thinking, and effective communication are critical soft skills for this position. These skills ensure accurate case evaluations, appropriate care decisions, and efficient collaboration with healthcare providers and payer organizations.

What is an InterQual?

An InterQual job typically involves using InterQual criteria—a set of evidence-based guidelines—to assess medical necessity for healthcare services. Professionals in these roles, such as nurses or case managers, review patient cases to ensure treatments align with best practices and insurance requirements. They work in hospitals, insurance companies, or healthcare organizations to support utilization management and improve patient care efficiency. Strong clinical knowledge and familiarity with InterQual software are often required for these positions.

What are the most commonly searched types of Interqual jobs in Colorado? The most popular types of Interqual jobs in Colorado are:
What are popular job titles related to Interqual jobs in Colorado? For Interqual jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Interqual jobs in Colorado look for? The top searched job categories for Interqual jobs in Colorado are:
Interqual jobs near you
Infographic showing various Interqual job openings in Colorado as of August 2026, with employment types broken down into 4% As Needed, 68% Full Time, 14% Part Time, and 14% Contract. Highlights an 88% In-person, 2% Hybrid, and 10% Remote job distribution, with an average salary of $94,093 per year, or $45.2 per hour.

Senior Utilization Management Nurse

Integrated Resources INC

Denver, CO • On-site

Full-time

Medical, Life

Re-posted 10 days ago

Job description

Company Description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

Details:
Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria defined by the Plan's various lines of business and Center of Medicare & Medicaid Services ("CMS") regulatory requirements. Completes clinical review to determine whether a request can be approved using nationally recognized criteria such as InterQual or MCG, or requires additional review by the Plan's Medical Director.
MINIMUM QUALIFICATIONS:
Education:
Bachelor's degree in Nursing. A combination of education and experience may be substituted for the B.S.N. requirement.
Experience:
Typically, three years of medical utilization management experience working with a health insurance plan, hospital, skilled nursing facility, or surgical center. Managed Care experience is highly preferred.

Qualifications

Responsibilities:
Facility seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department.
Must have BSN, 3 years' experience in medical utilization management, and experience working with a health insurance plan.
Managed Care experience is preferred however hospital experience is also considered.
Seeking highly skilled individual with experience with InterQual and MCG.
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various lines of business and Center of Medicare & Medicaid Services.

Additional Information

Regards,

Riya Khem

Life Science Recruiter

Integrated Resources, Inc.

IT Life Sciences Allied Healthcare CRO

(Direct) 732-844-8721 | (W) 732-549-2030 x 311 | (F) 732-549-5549

"INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)




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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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