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Interqual Jobs (NOW HIRING)

CarePoint Health

Case Manager RN

Bayonne, NJ

NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer ...

Talencia

Registered Nurse - Case Manager

Torrance, CA · On-site

$70 - $74/hr

Utilize InterQual criteria to determine medical necessity and level of care * Develop and implement patient-centered treatment and transition plans * Coordinate services across multiple disciplines ...

CarePoint Health

Case Manager RN

Bayonne, NJ

NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer ...

CarePoint Health

Case Manager RN

Bayonne, NJ · On-site

NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer ...

CarePoint Health

Case Manager RN

Bayonne, NJ

NJ RN License, Solid Case Management Medical/Surgical and Behavioral Health Background, InterQual and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer ...

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$89.5K

$163K

How much do interqual jobs pay per year?

As of May 31, 2026, the average yearly pay for interqual in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

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 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 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.
More about Interqual jobs
What cities are hiring for Interqual jobs? Cities with the most Interqual job openings:
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Interqual jobs near you
Infographic showing various Interqual job openings in the United States as of May 2026, with employment types broken down into 6% As Needed, 71% Full Time, 15% Part Time, and 8% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.