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.
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.
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 ...
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 ...
Utilization Review Registered Nurse : On Site Position
Meeker, CO · On-site
$33.50 - $49/hr
InterQual, Milliman Care Guidelines), and payer specific guidelines. - Communicate effectively with attending physicians, residents, and other healthcare providers regarding medical necessity ...
Utilization Review Registered Nurse : On Site Position
Meeker, CO · On-site
$33.50 - $49/hr
InterQual, Milliman Care Guidelines), and payer specific guidelines. - Communicate effectively with attending physicians, residents, and other healthcare providers regarding medical necessity ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/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 ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/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 ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/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 ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/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 ...
RN Case Manager Weekend Plan
$40.15 - $58.58/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 ...
RN Case Manager Weekend Plan
$40.15 - $58.58/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 ...
RN Case Manager Weekend Plan
$40.15 - $58.58/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 ...
RN Case Manager Weekend Plan
$40.15 - $58.58/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 ...
RN Case Manager Weekend Plan
Aurora, CO · On-site
$40.15 - $58.58/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 ...
RN Case Manager Weekend Plan
Aurora, CO · On-site
$40.15 - $58.58/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 ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
Behavioral Health Utilization Management Clinical Coordinator - Remote in Colorado preferred
Grand Junction, CO · Hybrid
MCG criteria, ASAM criteria, and InterQual criteria * Participates in annual Inter-Rater Reliability testing and pass with a score of 90% or higher * If an incomplete authorization request is ...
Behavioral Health Utilization Management Clinical Coordinator - Remote in Colorado preferred
Grand Junction, CO · Hybrid
MCG criteria, ASAM criteria, and InterQual criteria * Participates in annual Inter-Rater Reliability testing and pass with a score of 90% or higher * If an incomplete authorization request is ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/hr
Interqual experience preferred Benefits HCA HealthONE Aurora, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/hr
Interqual experience preferred Benefits HCA HealthONE Aurora, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience - Preferred Benefits HCA HealthONE Sky Ridge, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience - Preferred Benefits HCA HealthONE Sky Ridge, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
Registered Nurse Case Manager in Denver, CO
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
Registered Nurse Case Manager in Denver, CO
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager in Denver, CO
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager in Denver, CO
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager
$40.15 - $58.58/hr
Interqual experience preferred Benefits HCA HealthONE Aurora, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs ...
RN Case Manager
$40.15 - $58.58/hr
Interqual experience preferred Benefits HCA HealthONE Aurora, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience - Preferred Benefits HCA HealthONE Sky Ridge, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience - Preferred Benefits HCA HealthONE Sky Ridge, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience Preferred HCA HealthONE Presbyterian St. Luke's, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/hr
Interqual experience preferred Benefits HCA HealthONE Aurora, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs ...
Registered Nurse (RN) - Hiring Now!
$40.15 - $58.58/hr
Interqual experience preferred Benefits HCA HealthONE Aurora, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience - Preferred Benefits HCA HealthONE Sky Ridge, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
RN Case Manager
$40.15 - $58.58/hr
InterQual experience - Preferred Benefits HCA HealthONE Sky Ridge, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...
Nurse
Lakewood, CO · On-site +1
$82K - $155K/yr
Applies evidence-based practice, medical research, and standardized review tools (e.g., SEOCs, InterQual) to clinical decision-making. * Participates in quality improvement initiatives at the program ...
Nurse
Lakewood, CO · On-site +1
$82K - $155K/yr
Applies evidence-based practice, medical research, and standardized review tools (e.g., SEOCs, InterQual) to clinical decision-making. * Participates in quality improvement initiatives at the program ...
Interqual information
See Colorado salary details
$41K - $52.9K
15% of jobs
$52.9K - $64.7K
8% of jobs
$66.4K is the 25th percentile. Wages below this are outliers.
$64.7K - $76.6K
15% of jobs
The median wage is $84.1K / yr.
$76.6K - $88.4K
20% of jobs
$88.4K - $100.3K
11% of jobs
$106.2K is the 75th percentile. Wages above this are outliers.
$100.3K - $112.1K
13% of jobs
$112.1K - $124K
5% of jobs
$124K - $135.8K
3% of jobs
$135.8K - $147.7K
4% of jobs
$147.7K - $159.5K
3% of jobs
$159.5K - $171.4K
3% of jobs
$41K
$94.1K
$171.4K
How much do interqual jobs pay per year?
What jobs pay 2000 a day?
What are the typical daily responsibilities of someone working with InterQual criteria in a healthcare setting?
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 jobs pay $10,000 a month without a degree?
What are the key skills and qualifications needed to thrive in the Interqual position, and why are they important?
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 does InterQual do?
What is the least stressful healthcare job?
What is an InterQual job?
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.

Full-time
Medical, Life
Posted 15 days ago
Job 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.
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.
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.
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)
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