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Interqual Jobs in Michigan (NOW HIRING)

Garden City Hospital

Case Manager - RN

Garden City, MI · On-site

Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate, preferred Employment StatusPer DiemShiftDaysEqual Employment Opportunity Company is an equal employment ...

Prime Healthcare

Case Manager - RN

Garden City, MI

Preferred Qualifications: 4. Five years of acute care nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual Criteria preferred. 7. Current BCLS ...

Corewell Health

RN Care Coordinator

Wayne, MI · On-site

May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue ...

New

Spectrum Health

RN Care Coordinator

Trenton, MI

May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue ...

Spectrum Health

RN Care Coordinator

Grosse Pointe, MI · On-site

May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue ...

Corewell Health

RN Care Coordinator

Royal Oak, MI · On-site

... uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff ...

Corewell Health

RN Care Coordinator

Royal Oak, MI · On-site

... uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff ...

Corewell Health

RN Care Coordinator Rehab inpatient

Taylor, MI · On-site

$34.50 - $41.75/hr

May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue ...

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Interqual information

See Michigan salary details

$34K

$78K

$142.1K

How much do interqual jobs pay per year?

As of Aug 6, 2026, the average yearly pay for interqual in Michigan is $77,993.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,200.00 and $91,100.00 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 Michigan? The most popular types of Interqual jobs in Michigan are:
What are popular job titles related to Interqual jobs in Michigan? For Interqual jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Interqual jobs in Michigan look for? The top searched job categories for Interqual jobs in Michigan are:
What cities in Michigan are hiring for Interqual jobs? Cities in Michigan with the most Interqual job openings:
Interqual jobs near you
Infographic showing various Interqual job openings in Michigan as of July 2026, with employment types broken down into 7% As Needed, and 93% Full Time. Highlights an 72% In-person, 9% Hybrid, and 19% Remote job distribution, with an average salary of $77,993 per year, or $37.5 per hour.

Case Manager - RN

Garden City Hospital

Garden City, MI • On-site

Contractor

Re-posted 8 days ago

Garden City Hospital rating

6.2

Company rating: 6.2 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

821st of 1,054 rated hospitals

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden City Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

At Garden City Hospital, we pride ourselves on community involvement and commitment to preserving access to quality and compassionate healthcare. We are a state-of-the-art medical facility with over 300 licensed beds and a teaching hospital, offering medical education to students, residents and fellows from across the country. The residency and fellowship programs offer graduate medical education to more than 80 trainees in specialties. Garden City Hospital has an award-winning staff of over 350 of the area's best and brightest physicians from almost every specialty. Learn more at www.gch.org.

Responsibilities

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.  Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care.  The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. 

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required Qualifications:

1. Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license2. At least one year experience in case management, discharge planning or nursing management3. Experience and knowledge in basic to intermediate computer skills.Preferred Qualifications:

4. Five years of acute care nursing experience.  preferred5. CCM or obtained within 1year6. Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate, preferred

Employment StatusPer DiemShiftDaysEqual Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

 Employment Type: CONTRACTOR

What Garden City Hospital employees say

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Hours and flexibility

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