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Interqual Jobs in Georgia (NOW HIRING)

Piedmont Healthcare Inc.

RN, Care Manager

Atlanta, GA · On-site

Experience using InterQual or Milliman Preferred Licenses and Certifications * RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required * Certification in Case or ...

Piedmont Healthcare Inc.

RN, Care Manager

Atlanta, GA · On-site

Experience using InterQual or Milliman Preferred Licenses and Certifications * RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required * Certification in Case or ...

Piedmont Healthcare Inc.

RN, Care Manager

Atlanta, GA · On-site

Experience using InterQual or Milliman Preferred Licenses and Certifications * RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required * Certification in Case or ...

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Interqual information

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 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 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.

What are the most commonly searched types of Interqual jobs in Georgia? The most popular types of Interqual jobs in Georgia are:
What are popular job titles related to Interqual jobs in Georgia? For Interqual jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Interqual jobs in Georgia look for? The top searched job categories for Interqual jobs in Georgia are:
Interqual jobs near you
Infographic showing various Interqual job openings in Georgia as of July 2026, with employment types broken down into 6% As Needed, 72% Full Time, 14% Part Time, 1% Temporary, and 7% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution.
Director of Case Management

Director of Case Management

Dorminy Medical Center

Fitzgerald, GA • On-site

Full-time

Posted 20 days ago

Dorminy Medical Center rating

7.2

Company rating: 7.2 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

398th of 1,020 rated hospitals

Job description

Job Type
Fulltime
Category
Clinical
Contract Type
Permanent
Job Description
This position is responsible for the overall Case Management of the facility. Which inclues maintaining overall departmental operations in accordance with the facilities mission and philosophy.
Job Requirements
Nursing Degree with case management experience.
Experience
Experience in Case Management with demonstrated leadership qualities, effective communication at all levels, knowledge of Interqual criteria.

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