RN Utilization Manager
Middleburg Heights, OH · On-site
$2.0K - $2.2K/wk
Previous experience with screening criteria Cerner, InterQual, and MCG * Unencumbered RN OH License * ACM/CCM certification - nice to have
Quick apply
RN Utilization Manager
Middleburg Heights, OH · On-site
$2.0K - $2.2K/wk
Previous experience with screening criteria Cerner, InterQual, and MCG * Unencumbered RN OH License * ACM/CCM certification - nice to have
RN Utilization Manager
Middleburg Heights, OH · On-site
$2.0K - $2.2K/wk
Previous experience with screening criteria Cerner, InterQual, and MCG * Unencumbered RN OH License * ACM/CCM certification - nice to have
Quick apply
RN Utilization Manager
Middleburg Heights, OH · On-site
$2.0K - $2.2K/wk
Previous experience with screening criteria Cerner, InterQual, and MCG * Unencumbered RN OH License * ACM/CCM certification - nice to have
RN - Utilization Manager
Middleburg Heights, OH · On-site
$1.8K - $2.1K/wk
Cerner, InterQual, and MCG * Active, unencumbered Ohio RN license * ACM or CCM certification preferred
Quick apply
RN - Utilization Manager
Middleburg Heights, OH · On-site
$1.8K - $2.1K/wk
Cerner, InterQual, and MCG * Active, unencumbered Ohio RN license * ACM or CCM certification preferred
Case Manager/Social Worker - Substance Abuse Program Coordinator
$20.75 - $27.25/hr
Actively use InterQual/Milliman criteria to evaluate each patient. Determine level of care and inform physician before written orders, using InterQual/Milliman criteria. Document assessment and ...
Case Manager/Social Worker - Substance Abuse Program Coordinator
$20.75 - $27.25/hr
Actively use InterQual/Milliman criteria to evaluate each patient. Determine level of care and inform physician before written orders, using InterQual/Milliman criteria. Document assessment and ...
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
Provider Claims, Appeals and Denials - certain services require prior authorization (PA) from the Utilization Management (UM) department * 6 + months of Interqual experience * 6+ months of Coding ...
Provider Claims, Appeals and Denials - certain services require prior authorization (PA) from the Utilization Management (UM) department * 6 + months of Interqual experience * 6+ months of Coding ...
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER SUPPORT
Middletown, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER SUPPORT
Middletown, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER - Part Time
Dayton, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER - Part Time
Dayton, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER
Dayton, OH · On-site
$19.50 - $25/hr
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER - Part Time
Dayton, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER - Part Time
Dayton, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
CASE MANAGER - Part Time
Dayton, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
CASE MANAGER - Part Time
Dayton, OH · On-site
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring indicators and feedback mechanisms required.
Preferred Qualifications: 5. Five years of acute care nursing experience. preferred 6. CCM or obtained within 1year 7. Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI ...
Preferred Qualifications: 5. Five years of acute care nursing experience. preferred 6. CCM or obtained within 1year 7. Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI ...
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements preferred, * Knowledge of Microsoft Office is required
Interqual information
See Ohio salary details
$37.1K - $47.8K
15% of jobs
$47.8K - $58.5K
8% of jobs
$60K is the 25th percentile. Wages below this are outliers.
$58.5K - $69.2K
15% of jobs
The median wage is $76K / yr.
$69.2K - $79.9K
20% of jobs
$79.9K - $90.7K
11% of jobs
$96K is the 75th percentile. Wages above this are outliers.
$90.7K - $101.4K
13% of jobs
$101.4K - $112.1K
5% of jobs
$112.1K - $122.8K
3% of jobs
$122.8K - $133.5K
4% of jobs
$133.5K - $144.2K
3% of jobs
$144.2K - $155K
3% of jobs
$37.1K
$85.1K
$155K
How much do interqual jobs pay per year?
As of Jul 26, 2026, the average yearly pay for interqual in Ohio is $85,071.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,300.00 and $99,300.00 per year, depending on experience, location, and employer.
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 Ohio? The most popular types of Interqual jobs in Ohio are:
What are popular job titles related to Interqual jobs in Ohio? For Interqual jobs in Ohio, the most frequently searched job titles are:
- Night Utilization Review Nurse
- Physician Case Reviewer
- Remote Telephonic Nurse
- Cvs Health Utilization Management
- Manager Utilization Management
- Appeals Nurse Consultant
- No Experience Utilization Management Nurse
- Part Time Utilization Review Nurse
- Evening Optum Health Utilization Review
- Contract Hedis Review Nurse
What job categories do people searching Interqual jobs in Ohio look for? The top searched job categories for Interqual jobs in Ohio are:
What cities in Ohio are hiring for Interqual jobs? Cities in Ohio with the most Interqual job openings:
$2.0K - $2.2K/wk
Full-time
Posted 5 days ago
Job description
Job Summary
RN Utilization Manager
Talented Medical Solutions
Full-time, Contract
In-Office | Middleburg Heights, OH, United States
Schedule: Full-Time 40 hours per week, 5 (8) hour shifts 8a-4:30p.
Start Date: ASAP or 12/08 - URGENT NEED
Requirements:
5 years recent experience in clinical nursing
Previous case management or Utilization Management experience
Previous experience with screening criteria Cerner, InterQual, and MCG
Unencumbered RN OH License
ACM/CCM certification - nice to have
About Talented Medical Solutions
Sourced by ZipRecruiter
Industry
Outpatient health care
Company size
11 - 50 Employees
Headquarters location
Oro Valley, AZ, US
Year founded
2020