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Interqual Jobs in New York (NOW HIRING)

CarePoint Health

Case Manager RN

Bayonne, NJ

NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer ...

CarePoint Health

Case Manager RN

Bayonne, NJ · On-site

NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer ...

CarePoint Health

Case Manager RN

Bayonne, NJ · On-site

NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer ...

CarePoint Health

Case Manager RN

Bayonne, NJ

Management/Case Management, InterQual knowledgeable (Behavioral Health InterQual a plus), good computer skills. Full Time 8:00am-4:30pm every other weekend every other holiday ** An Equal Opportunity ...

CarePoint Health

Case Manager RN

Bayonne, NJ

Management/Case Management, InterQual knowledgeable (Behavioral Health InterQual a plus), good computer skills. Full Time 8:00am-4:30pm every other weekend every other holiday ** An Equal Opportunity ...

CarePoint Health

Case Manager RN

Bayonne, NJ · On-site

Management/Case Management, InterQual knowledgeable (Behavioral Health InterQual a plus), good computer skills. Full Time 8:00am-4:30pm every other weekend every other holiday ** An Equal Opportunity ...

Hurc LLC

Physician Advisor

Short Hills, NJ · On-site

Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and commercial payer audits * Partner with HIM ...

Hurc LLC

Physician Advisor

Short Hills, NJ · On-site

Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and commercial payer audits * Partner with HIM ...

HURC

Physician Advisor

Short Hills, NJ · Remote

Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and commercial payer audits * Partner with HIM ...

Hurc LLC

Physician Advisor

Short Hills, NJ · Remote

Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and commercial payer audits * Partner with HIM ...

St Barnabas Hospital

Care Manager

Bronx, NY · On-site

Secures copies of the medical record as needed. 8. Reviews elective ambulatory surgery cases using the Interqual Inpatient Criteria to determine appropriateness of inpatient setting, and make ...

St. Barnabas

Care Manager

Bronx, NY · On-site

Secures copies of the medical record as needed. 8. Reviews elective ambulatory surgery cases using the Interqual Inpatient Criteria to determine appropriateness of inpatient setting, and make ...

Mercor

Utilisation Management Expert - RN

New York, NY · Remote

$100 - $150/hr

Conduct and oversee clinical reviews against InterQual , MCG , or Milliman care guidelines to support admission and level-of-care determinations. * Manage the physician advisor program to support ...

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All JobsInterqual JobsInterqual Jobs in New York

Interqual information

See New York salary details

$42.7K

$97.9K

$178.3K

How much do interqual jobs pay per year?

As of Aug 24, 2026, the average yearly pay for interqual in New York is $97,897.00, according to ZipRecruiter salary data. Most workers in this role earn between $70,600.00 and $114,300.00 per year, depending on experience, location, and employer.

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 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 are the most commonly searched types of Interqual jobs in New York?

The most popular types of Interqual jobs in New York are:

What are popular job titles related to Interqual jobs in New York?

For Interqual jobs in New York, the most frequently searched job titles are:

What job categories do people searching Interqual jobs in New York look for?

The top searched job categories for Interqual jobs in New York are:

What cities in New York are hiring for Interqual jobs?

Cities in New York with the most Interqual job openings:

Interqual jobs near you
Infographic showing various Interqual job openings in New York as of August 2026, with employment types broken down into 5% As Needed, 69% Full Time, 18% Part Time, and 8% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $97,897 per year, or $47.1 per hour.

Case Manager RN

CarePoint Health

Bayonne, NJ

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 13 days ago

Job description

CarePoint Health is one of New Jersey’s leading health care systems comprised of three long-standing and highly-regarded hospitals – Christ Hospital in Jersey City, Hoboken University Medical Center and Bayonne Medical Center. CarePoint united three area hospitals to provide 360-degree-coordinated care by integrating the medical facilities and physician networks associated with these institutions. With over 4,500 employees, CarePoint is the largest private employer in Hudson County, New Jersey and each year provides care to over 300,000 individuals.

CarePoint prides itself on its patient-focused approach to care delivery, with an emphasis on preventative medicine, health education, and disease management. Leveraging its vast network of physicians and healthcare experts, CarePoint is quickly becoming recognized as a leader in the broader healthcare landscape as it pioneers creative solutions to address urgent population health needs.


MAIN FUNCTIONS:

To oversee that patient care is provided consistently with regulatory and compliance standards

To facilitate efficient patient movement through the acute phase of an illness episode and ensure linkage with post-discharge care providers

REQUIREMENTS/QUALIFICATIONS: NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer Competence, High Degree of Oral, Written and Interpersonal Skills, Organized, Energetic, Resourceful, Highly Motivated

EDUCATION: Bachelor’s Degree in Nursing, Masters in Nursing or in a Health-Related Field Preferred


  • Bachelor’s Degree in Nursing Preferred
  • Current New Jersey RN  License
  • Minimum 3 years of acute hospital experience including Utilization
  • Management/Case Management, InterQual knowledgeable (Behavioral Health InterQual a plus), good computer skills.

• Competitive pay
• Medical, dental, and vision insurance
• 401k with Company match
• Generous paid time off
• Paid Holidays
• Tuition Reimbursement
• Advancement and career development opportunities

CarePoint Health is an Equal Opportunity Employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, gender, age, religion, disability, sexual orientation, veteran status, marital status, or any other characteristic protected by law.


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