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Interqual Jobs in Texas (NOW HIRING)

InterQual experience preferred Benefits Medical City Fort Worth, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...

Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established ...

Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established ...

InterQual experience preferred Benefits Medical City Fort Worth, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...

Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established ...

InterQual experience preferred Benefits Medical City Lewisville, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and ...

Showing results 41-60

Interqual information

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 Texas? The most popular types of Interqual jobs in Texas are:
What cities in Texas are hiring for Interqual jobs? Cities in Texas with the most Interqual job openings:
Infographic showing various Interqual job openings in Texas as of August 2026, with employment types broken down into 5% As Needed, 66% Full Time, 12% Part Time, and 17% Contract. Highlights an 86% In-person, 2% Hybrid, and 12% Remote job distribution.

RN Case Manager

Mission Hospital

Fort Worth, TX • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago


Mission Hospital (Asheville) rating

6.3

Company rating: 6.3 out of 10

Based on 44 frontline employees who took The Breakroom Quiz

778th of 1,055 rated hospitals


Job description

Ready for a role that supports your unique calling in patient care and fits your life? At Medical City Fort Worth, you'll find clear pathways to advance backed by our unmatched nationwide transfer policy that lets you grow your career when the time is right for you. With mentorship opportunities, clinical education courses, professional certification support, and educational assistance, you will have all the resources you need to build the career of a lifetime.
Job Summary and Qualifications
* This is a Full Time Day Shift position, hours are typically 8:00am-4:30pm Monday - Friday with some weekends *
Our RN Case Managers raise the bar by providing clinical expertise and the highest quality care in the most compassionate way. The RN Case Manager is responsible for promoting patient-centered care by coordinating the plan of care for the patient stay, managing the length of stay, ensuring appropriate resource management, and developing a safe appropriate discharge plan in collaboration with the multidisciplinary team. The RN Case Manager facilitates the progression and transition of care using established criteria and in conjunction with the multidisciplinary team. The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization.
What You Will Do In This Role:

  • Performs a comprehensive assessment of psychosocial, medical and discharge needs of patients/family along with an assessment of resources appropriate and available to the patient/family
  • Reassesses the patient's clinical condition as indicated. Considers patient's readmission status or risk of readmission and develops strategies to mitigate including education on appropriately accessing healthcare resources, preventative education, and community based resources.
  • Coordinates the plan of care and drives the discharge plan by collaborating with the multidisciplinary health care team and in particular with the patient's physician to facilitate a successful care transition
  • In partnership with Social Services, the RN CM is responsible for ensuring the post-acute medical needs and level of care are appropriate
  • The RN CM is responsible for timely referral to Social Services when risk factors for psychosocial determinants of health are identified
  • Involves patient, family/responsible/significant others in identifying and clarifying needs and expectations to develop mutual and realistic goals
  • Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established chain of command
  • Makes appropriate referrals to third party payer, disease and case management programs for recurring patients and patients with chronic disease states
  • Facilitates patient throughput with an ongoing focus on an effective care transition, quality and efficiency
  • Documents professional recommendations, discharge plan, care coordination interventions, and case management activities to effectively communicate to all members of the health care team
  • Align patient's needs with available resources to ensure a safe discharge / transition
  • Acts as a liaison through effective and professional communications between and with physicians, patient / family, hospital staff, and outside agencies
  • Directs activities to identify and provide for the needs of the under-resourced patient population to include patient education activities, patient assistance programs, and community-based resources
  • Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives
  • Serve as an advocate for patient's rights, needs, and values; ensuring that patients' ethnic, cultural, or religious values, beliefs, preferences and needs are considered and aligned
What qualifications you will need:
  • Registered Nurse with current TX state license required
  • Associate Degree in Nursing or Nursing diploma required, Bachelor's Degree in Nursing preferred
  • 3+ years of clinical hospital nursing experience required OR 2+ years experience in case management required
  • Certification in case management preferred
  • InterQual experience preferred
Benefits
Medical City Fort Worth, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
Medical City Fort Worth is a 350+ bed full-service Magnet Designated hospital. It is located in the heart of the medical district. Medical City Fort Worth serves as a tertiary referral center for Tarrant County and many counties within a 90 mile radius. We offer comprehensive diagnostic and treatment services. Our specialties include cardiac care, neurosciences and oncology. We have surgical services, orthopedics, kidney transplants and emergency care. We offer three ER locations, including two off campus ER located in Burleson and White Settlement. Medical City Fort Worth is a designated comprehensive stroke center. We are a Joint Commission chest pain center. We are a part of the Medical City network of hospitals. Patients are ensured access to medical experts and advanced healthcare innovations across the network.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing's future."
Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC
Senior Vice President and Chief Nurse Executive
HCA Healthcaret
Join a family that cares about every stage in your career! We are interviewing candidates for our RN Case Manager opening. Apply today and a member of our Talent Acquisition team will reach out.
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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