We deliver strategic workforce solutions that help you manage your talent and business more ... Familiar with interqual or MCG software Additional Information Kind Regards, Kavita Kumari Clinical ...
We deliver strategic workforce solutions that help you manage your talent and business more ... Familiar with interqual or MCG software Additional Information Kind Regards, Kavita Kumari Clinical ...
Director - Case Management
Detroit, MI · On-site
McKesson InterQual experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred. Skills Required 1. Analytical ability to serve in an advisory/consultative ...
Director - Case Management
Detroit, MI · On-site
McKesson InterQual experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred. Skills Required 1. Analytical ability to serve in an advisory/consultative ...
McKesson InterQual experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred.
McKesson InterQual experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred.
McKesson InterQual ® experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred. Central Business Solutions, Inc(A Certified Minority Owned Organization ...
McKesson InterQual ® experience preferred. Business planning experience preferred. 4. Accredited Case Manager (ACM) preferred. Central Business Solutions, Inc(A Certified Minority Owned Organization ...
Please do not submit LPNs Familiar with MCG and InterQual criteria. Familiar with Medicaid and Medicare Time frames. Manager would like to see 4 years experience with clinical practice. Utilization ...
Please do not submit LPNs Familiar with MCG and InterQual criteria. Familiar with Medicaid and Medicare Time frames. Manager would like to see 4 years experience with clinical practice. Utilization ...
... the InterQual inpatient list based on payer criteria used. Hours are Monday - Friday from 830am ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
... the InterQual inpatient list based on payer criteria used. Hours are Monday - Friday from 830am ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
RN Case Manager
Grand Rapids, MI · On-site
Are you an experienced ER Case Manager in Grand Rapids, MI looking for a new opportunity with a ... Interqual Experience preferred Additional Information If you are interested in applying to this ...
RN Case Manager
Grand Rapids, MI · On-site
Are you an experienced ER Case Manager in Grand Rapids, MI looking for a new opportunity with a ... Interqual Experience preferred Additional Information If you are interested in applying to this ...
... the InterQual inpatient list based on payer criteria used. Hours are Monday - Friday from 830am ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
... the InterQual inpatient list based on payer criteria used. Hours are Monday - Friday from 830am ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Case Manager - RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Employment Status Per Diem ...
Case Manager - RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Employment Status Per Diem ...
Case Manager RN
Garden City, MI · On-site
Responsible for the quality and resource management of all patients that are admitted to the ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Per Diem Days Company is an ...
Case Manager RN
Garden City, MI · On-site
Responsible for the quality and resource management of all patients that are admitted to the ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Per Diem Days Company is an ...
Case Manager - RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate ...
Case Manager - RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate ...
Case Manager - RN
Garden City, MI · On-site
Responsible for the quality and resource management of all patients that are admitted to the ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Per Diem Days Company is an ...
Case Manager - RN
Garden City, MI · On-site
Responsible for the quality and resource management of all patients that are admitted to the ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Per Diem Days Company is an ...
Case Manager RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Employment Status Per Diem ...
Case Manager RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... InterQual Criteria preferred. 7. Current BCLS certificate, preferred Employment Status Per Diem ...
Case Manager RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate ...
Case Manager RN
Garden City, MI · On-site
Responsibilities Responsible for the quality and resource management of all patients that are ... Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate ...
Registered Nurse
Detroit, MI · On-site +1
$30 - $35/hr
Should have experience with InterQual Requirement: * Bachelor's degree in nursing, allied health ... One year health insurance plan experience or managed care environment preferred. * Registered Nurse ...
Registered Nurse
Detroit, MI · On-site +1
$30 - $35/hr
Should have experience with InterQual Requirement: * Bachelor's degree in nursing, allied health ... One year health insurance plan experience or managed care environment preferred. * Registered Nurse ...
... manage multiple priorities. Work independently and handle multiple projects simultaneously. Knowledge of applicable state, and federal regulations. In depth knowledge of Interqual and other ...
... manage multiple priorities. Work independently and handle multiple projects simultaneously. Knowledge of applicable state, and federal regulations. In depth knowledge of Interqual and other ...
Understand and use MCG/InterQual and other appropriate criteria. Document response to UM referrals. Support case management and physicians in the post-acute care process * Assist Hospital ...
Understand and use MCG/InterQual and other appropriate criteria. Document response to UM referrals. Support case management and physicians in the post-acute care process * Assist Hospital ...
Understand and use MCG/InterQual and other appropriate criteria. Document response to UM referrals. Support case management and physicians in the post-acute care process * Assist Hospital ...
Understand and use MCG/InterQual and other appropriate criteria. Document response to UM referrals. Support case management and physicians in the post-acute care process * Assist Hospital ...
Physician Advisor (IPAS)
Detroit, MI · On-site
Understand and use MCG/InterQual and other appropriate criteria. Document response to UM referrals. Support case management and physicians in the post-acute care process * Assist Hospital ...
Physician Advisor (IPAS)
Detroit, MI · On-site
Understand and use MCG/InterQual and other appropriate criteria. Document response to UM referrals. Support case management and physicians in the post-acute care process * Assist Hospital ...
Clinical Quality Assurance Coordinator (32277)
Southfield, MI · On-site
$26.50 - $31/hr
Familiarity with CMS guidelines, InterQual, Milliman/MCG, or payer policies. * Prior employment with insurance carriers, TPAs, or managed care organizations. * Must have strong knowledge of medical ...
Clinical Quality Assurance Coordinator (32277)
Southfield, MI · On-site
$26.50 - $31/hr
Familiarity with CMS guidelines, InterQual, Milliman/MCG, or payer policies. * Prior employment with insurance carriers, TPAs, or managed care organizations. * Must have strong knowledge of medical ...
Manager Interqual information
How does a Manager Interqual typically collaborate with clinical and administrative teams to ensure effective utilization review?
A Manager Interqual works closely with both clinical staff—such as physicians, nurses, and case managers—and administrative teams to implement and oversee the use of InterQual criteria in utilization review processes. They facilitate training, address questions about criteria application, and help resolve discrepancies between clinical recommendations and insurance requirements. Regular meetings and interdisciplinary rounds are common, ensuring that patient care decisions are well-documented and meet regulatory standards. This collaborative approach helps streamline approvals, reduce denials, and maintain high-quality patient care.
What is the difference between Manager Interqual vs Clinical Case Manager?
| Aspect | Manager Interqual | Clinical Case Manager |
|---|---|---|
| Credentials | Typically requires nursing or healthcare management certifications | Requires nursing or social work licensure and clinical experience |
| Work Environment | Healthcare organizations, utilization review departments | Hospitals, insurance companies, community health settings |
| Primary Focus | Utilization management, policy implementation, and compliance | Patient advocacy, care coordination, and discharge planning |
The Manager Interqual primarily oversees utilization review processes and policy adherence within healthcare organizations, often requiring management experience and specific certifications. In contrast, the Clinical Case Manager focuses on direct patient care, coordinating services, and ensuring appropriate treatment. Both roles are vital in healthcare but serve different functions related to patient care and resource management.
What are the key skills and qualifications needed to thrive as a Manager Interqual, and why are they important?
To excel as a Manager Interqual, you need a solid background in healthcare management, clinical guidelines, and utilization review processes, typically supported by a nursing or clinical degree and relevant experience. Familiarity with InterQual criteria, case management software, and healthcare compliance systems is crucial. Strong leadership, analytical thinking, and effective communication are valuable soft skills for guiding teams and collaborating with diverse stakeholders. These competencies ensure proper application of clinical criteria, optimize resource utilization, and support quality patient care and regulatory compliance.
What are Manager Interqual?
A Manager Interqual is a healthcare management professional responsible for overseeing the use and implementation of the InterQual criteria within a healthcare organization. InterQual is a set of evidence-based clinical decision support tools used to ensure appropriate hospital admissions, continued stays, and other medical services. The Manager Interqual leads teams that review cases for medical necessity, ensures compliance with regulatory requirements, and collaborates with clinical staff to optimize patient care and resource utilization. They also provide training on InterQual standards and help integrate these criteria into hospital processes.
What are the most commonly searched types of Interqual jobs in Michigan? The most popular types of Interqual jobs in Michigan are:
What cities in Michigan are hiring for Manager Interqual jobs? Cities in Michigan with the most Manager Interqual job openings:
Job description
Company Description
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
Job Description
Location: Troy, MI
Shift: M-F 8:30 am to 5 pmÂ
Duties:Â
Will be an inpatient UM, get cases from hospitals, review info about patient, enter info into computer system (interqual, or MCG) determine if it meets criteria, work with medical director for approval, notify Hospital of approval. Follow members from admission process all the way through to discharge, find discharge plan and where patient is being discharged to.Â
Top 3 Skills:Â
Strong Communication both verbal and writtenÂ
Attention to detailÂ
Computer skillsÂ
Qualifications
Must Haves:Â
UM experienceÂ
Computer skillsÂ
Licensed RN in the state of Michigan.Â
Nice to Have:Â
Familiar with interqual or MCG softwareÂ
Additional Information
Kind Regards,
Kavita Kumari
Clinical Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
DIRECT # - 732-844-8726
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996