Joliet, IL · On-site
$35.35 - $53.58/hr
Preferred Qualifications: 4. Five years of acute care nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual Criteria preferred. 7. Current BCLS ...
Joliet, IL · On-site
$35.35 - $53.58/hr
Preferred Qualifications: 4. Five years of acute care nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual Criteria preferred. 7. Current BCLS ...
Olympia Fields, IL · On-site
$85K - $123K/yr
Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Olympia Fields Hospital offers competitive compensation and a comprehensive benefits package that provides employees ...
Olympia Fields, IL · On-site
$85K - $123K/yr
Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Olympia Fields Hospital offers competitive compensation and a comprehensive benefits package that provides employees ...
Joliet, IL · On-site
$49 - $74/hr
Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate, preferred #LI-GM1 Pay Transparency Saint Joseph Medical Center - Joliet offers competitive compensation ...
Joliet, IL · On-site
$49 - $74/hr
Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate, preferred #LI-GM1 Pay Transparency Saint Joseph Medical Center - Joliet offers competitive compensation ...
$100K - $135K/yr
Preferred qualifications: 1. CCM or obtained within 1year2. BS or BSN or related field preferred.3. Current BCLS certificate preferred.4. Knowledge of Milliman Criteria and InterQual Criteria ...
$100K - $135K/yr
Preferred qualifications: 1. CCM or obtained within 1year2. BS or BSN or related field preferred.3. Current BCLS certificate preferred.4. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria ...
Olympia Fields, IL · On-site
$73K - $111K/yr
Knowledge of Milliman Criteria and InterQual Criteria preferred. * Experience and knowledge in basic to intermediate computer skills. Pay Transparency Olympia Fields Hospital offers competitive ...
Olympia Fields, IL · On-site
$73K - $111K/yr
Knowledge of Milliman Criteria and InterQual Criteria preferred. * Experience and knowledge in basic to intermediate computer skills. Pay Transparency Olympia Fields Hospital offers competitive ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Evanston, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Arlington Heights, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Arlington Heights, IL · On-site
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor authorization processes and ensures that the patient type assigned is accurate. * Facilitates the ...
Willowbrook, IL · On-site
Identifies when services no longer meet InterQual/Millman l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning ...
Willowbrook, IL · On-site
Identifies when services no longer meet InterQual/Millman l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning ...
Chicago, IL · On-site
Working knowledge of payor medical necessity criteria such as LOCUS, CALOCUS, MCG, InterQual, or payor specific criteria. * Working knowledge of HIPAA and Illinois MHDDCA confidentiality requirements ...
Chicago, IL · On-site
Working knowledge of payor medical necessity criteria such as LOCUS, CALOCUS, MCG, InterQual, or payor specific criteria. * Working knowledge of HIPAA and Illinois MHDDCA confidentiality requirements ...
Arlington Heights, IL · Remote
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria preferred * Clinical certification, such as case management certification, is beneficial. * Able to communicate and work collaboratively with a range of ...
New
Arlington Heights, IL · Remote
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria preferred * Clinical certification, such as case management certification, is beneficial. * Able to communicate and work collaboratively with a range of ...
New
Arlington Heights, IL · Remote
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria preferred * Clinical certification, such as case management certification, is beneficial. * Able to communicate and work collaboratively with a range of ...
New
Arlington Heights, IL · Remote
$40.45 - $62.70/hr
Knowledge of InterQual or MCG criteria preferred * Clinical certification, such as case management certification, is beneficial. * Able to communicate and work collaboratively with a range of ...
New
Chicago, IL · On-site
Working knowledge of payor medical necessity criteria such as LOCUS, CALOCUS, MCG, InterQual, or payor specific criteria. * Working knowledge of HIPAA and Illinois MHDDCA confidentiality requirements ...
Chicago, IL · On-site
Working knowledge of payor medical necessity criteria such as LOCUS, CALOCUS, MCG, InterQual, or payor specific criteria. * Working knowledge of HIPAA and Illinois MHDDCA confidentiality requirements ...
$40.2K - $51.8K
15% of jobs
$51.8K - $63.4K
8% of jobs
$65.1K is the 25th percentile. Wages below this are outliers.
$63.4K - $75K
15% of jobs
The median wage is $82.3K / yr.
$75K - $86.6K
20% of jobs
$86.6K - $98.2K
11% of jobs
$104K is the 75th percentile. Wages above this are outliers.
$98.2K - $109.9K
13% of jobs
$109.9K - $121.5K
5% of jobs
$121.5K - $133.1K
3% of jobs
$133.1K - $144.7K
4% of jobs
$144.7K - $156.3K
3% of jobs
$156.3K - $167.9K
3% of jobs
$40.2K
$92.2K
$167.9K
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.
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.
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.
The most popular types of Interqual jobs in Chicago, IL are:
For Interqual jobs in Chicago, IL, the most frequently searched job titles are:
The top searched job categories for Interqual jobs in Chicago, IL are:
$35.35 - $53.58/hr
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 2 days ago
6.4
Based on 289 frontline employees who took The Breakroom Quiz
648th of 898 rated healthcare providers
• Schedule: Days, 7:30a-4p, full-time,
• Facility: Prime Healthcare Saint Joseph Medical Center
• Location: Joliet, IL 60435
Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.
EDUCATION, EXPERIENCE, TRAINING
Required Qualifications:
1. Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
2. At least one year experience in case management, discharge planning or nursing management
3. Experience and knowledge in basic to intermediate computer skills.
Preferred Qualifications:
4. Five years of acute care nursing experience. preferred
5. CCM or obtained within 1year
6. Knowledge of Milliman Criteria and InterQual Criteria preferred.
7. Current BCLS certificate, preferred
#LI-GM1
Saint Joseph Medical Center - Joliet offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $35.35 to $53.58. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
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Hospitals
10,000+ Employees
Ontario, CA, US
