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
Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment Status Full Time Shift Days Equal Employment Opportunity Company is an equal employment opportunity employer.
RN Case Manager
East Liverpool, OH · On-site
Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment Status Full Time Shift Days Equal Employment Opportunity Company is an equal employment opportunity employer.
UTILIZATION SPECIALIST
Hudson, OH · On-site
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
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 ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
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 ...
Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment StatusFull TimeShiftDaysEqual Employment Opportunity Company is an equal employment opportunity employer. Company ...
Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment StatusFull TimeShiftDaysEqual Employment Opportunity Company is an equal employment opportunity employer. Company ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
Interqual, MCG) preferred * Excellent critical thinking and communication skills * Strong computer skills * Required licensure, certification or registry: * Current licensure by Ohio State Board of ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
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 ...
Previous experience with screening criteria including Cerner, InterQual, and MCG. * Excellent critical thinking and communication skills. * Strong computer skills. * ACM/CCM Certification helpful.
Previous experience with screening criteria including Cerner, InterQual, and MCG. * Excellent critical thinking and communication skills. * Strong computer skills. * ACM/CCM Certification helpful.
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 ...
Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required. Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred.
Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required. Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred.
RN Case Manager
East Liverpool, OH · On-site
Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment Status Full Time Shift Days Equal Employment Opportunity Company is an equal employment opportunity employer.
RN Case Manager
East Liverpool, OH · On-site
Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment Status Full Time Shift Days Equal Employment Opportunity Company is an equal employment opportunity employer.
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 ...
Minimum 1 year experience with utilization management, case management and knowledge of InterQual and MCG OR 5 years' relevant adult clinical experience. Process improvement experience. Knowledge ...
Minimum 1 year experience with utilization management, case management and knowledge of InterQual and MCG OR 5 years' relevant adult clinical experience. Process improvement experience. Knowledge ...
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:
Southwest General Health Center rating
6.9
Based on 46 frontline employees who took The Breakroom Quiz
553rd of 1,060 rated hospitals
Job description
Summary
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POSITION INFORMATION
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Position summary:
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The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for acute care case management to ensure the appropriateness of services, utilization of hospital resources, and quality of care rendered. Accurate and efficient application of screening criteria will be applied to identify and support patients being placed in the appropriate hospital level of care via emergency, scheduled, or direct admission processes. Combines clinical, business, and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous assessments, problem identification, and education, the Utilization Specialist facilitates the quality of health care delivery in the most cost-effective manner. The Utilization Specialist must be able to demonstrate the knowledge and skills necessary to provide services appropriate to age groups according to specific chronological age, developmental age, and/or psycho-social maturity. The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patients plan of care. The Utilization Specialists responsibility is to collect data and clinical review summaries on patients concurrently for both utilization review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The Utilization Specialist will communicate with physicians, hospital staff, outside agencies such as insurance companies, and patients regarding the assigned level of care and associated resource utilization.
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MINIMUM QUALIFICATIONS
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Education:
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Graduation from an accredited School of Nursing. BSN graduate preferred.
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Required length and type of experience:-
Minimum of five (5) years recent experience in clinical nursing or related nursing field. (e.g. Utilization Review or Case Management)
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Previous Care Management, Case Management or Utilization Management Experience preferred
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Previous experience with screening criteria (i.e. Interqual, MCG) preferred
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Excellent critical thinking and communication skills
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Strong computer skills
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Required licensure, certification or registry:-
Current licensure by Ohio State Board of Nursing.
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ACM/CCM Certification helpful
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What Southwest General Health Center employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Southwest General
Sourced by ZipRecruiter
Industry
Hospitals
Company size
1,001 - 5,000 Employees
Headquarters location
Middleburg Heights, OH, US
Year founded
1920