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
CASE MANAGER
$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
$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
$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
$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
$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
$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.
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
RN Case Manager
East Liverpool, OH · On-site
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 ...
RN Case Manager
East Liverpool, OH · On-site
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 ...
Travel Nurse RN - Med Surg - $2,139 per week
Middleburg Heights, OH · On-site
$2.1K/wk
Medical
Dental
Vision
Life
Retirement
Familiarity with screening criteria, including Cerner, InterQual, and MCG, is required. Education Requirements * Graduation from an accredited School of Nursing is required. * BSN graduate is ...
Travel Nurse RN - Med Surg - $2,139 per week
Middleburg Heights, OH · On-site
$2.1K/wk
Medical
Dental
Vision
Life
Retirement
Familiarity with screening criteria, including Cerner, InterQual, and MCG, is required. Education Requirements * Graduation from an accredited School of Nursing is required. * BSN graduate is ...
Travel Nurse RN - Med Surg
Middleburg Heights, OH · On-site
Medical
Dental
Vision
Life
Retirement
Familiarity with screening criteria, including Cerner, InterQual, and MCG, is required. Education Requirements * Graduation from an accredited School of Nursing is required. * BSN graduate is ...
Travel Nurse RN - Med Surg
Middleburg Heights, OH · On-site
Medical
Dental
Vision
Life
Retirement
Familiarity with screening criteria, including Cerner, InterQual, and MCG, is required. Education Requirements * Graduation from an accredited School of Nursing is required. * BSN graduate is ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
RN Case Manager
East Liverpool, OH · On-site
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 ...
RN Case Manager
East Liverpool, OH · On-site
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 ...
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 Aug 17, 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 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 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:
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:
Job description
General Summery
Position: Case Manager (RN)
Dept: Integrated Care Management Program
Shift: Part Time -0830-1700 / 48 Hours per Pay
The Case Manager is a registered nurse responsible for individualized patient assessment and care coordination, and transition planning to promote maximal outcomes in relation to appropriate length of stay, effective use of resources and established guidelines of care. Additional responsibilities include facilitation of interdisciplinary team collaboration, liaison between the patient, physician, payor, family/significant others in regards to care coordination and transitional care needs. This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource allocation, team management and communication skills. Promotes care coordination and effective utilization of resources through the assessment of patient care needs during the hospitalization and across the health care continuum. Success is measured against achievement of targeted goals and outcomes as generated by defined expectations through care team collaboration.
Education: BSN required.
Licensure: Registered Nurse with valid Ohio license.
Certification: Certification in area of clinical specialty preferred.
Experience: Minimum of three years of relevant clinical experience in area of patient population within last five years. Expertise in healthcare reimbursement, transition planning and case management preferred. Experience with a clinical documentation management program preferred, knowledge of performance improvement process preferred.
Skills/Other: Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and Integrated Care Team members. Negotiation skills, conflict resolution skills and assertive communication skills 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. Basic computer skills required.
Licensure: Registered Nurse with valid Ohio license.
Certification: Certification in area of clinical specialty preferred.
Experience: Minimum of three years of relevant clinical experience in area of patient population within last five years. Expertise in healthcare reimbursement, transition planning and case management preferred. Experience with a clinical documentation management program preferred, knowledge of performance improvement process preferred.
Skills/Other: Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and Integrated Care Team members. Negotiation skills, conflict resolution skills and assertive communication skills 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. Basic computer skills required.