Within the System Capacity Command Center (SC3) at Henry Ford Health, the Access Management Nurse ... Experience facilitating InterQual reviews, admission process preferred. Experience with systems ...
New
Within the System Capacity Command Center (SC3) at Henry Ford Health, the Access Management Nurse ... Experience facilitating InterQual reviews, admission process preferred. Experience with systems ...
New
RN Care Coordinator
Grosse Pointe, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Grosse Pointe, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator Rehab inpatient
Taylor, MI · On-site
$34.50 - $41.75/hr
Candidate will function as a Case Management educator and also be expected to provide coverage at ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator Rehab inpatient
Taylor, MI · On-site
$34.50 - $41.75/hr
Candidate will function as a Case Management educator and also be expected to provide coverage at ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Royal Oak, MI · On-site
... InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when ... Uses defined resources to guide decisions, including Medical Director Care Management, Physician ...
RN Care Coordinator
Royal Oak, MI · On-site
... InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when ... Uses defined resources to guide decisions, including Medical Director Care Management, Physician ...
RN Care Coordinator Rehab inpatient
Taylor, MI · On-site
$34.50 - $41.75/hr
Candidate will function as a Case Management educator and also be expected to provide coverage at ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator Rehab inpatient
Taylor, MI · On-site
$34.50 - $41.75/hr
Candidate will function as a Case Management educator and also be expected to provide coverage at ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Trenton, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Trenton, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Trenton, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Trenton, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
The MSW Case Manager (CM) must have a high level of expertise and skill to create highly effective ... criteria/InterQual Guidelines) to assure quality care is being provided to the patient, in the ...
The MSW Case Manager (CM) must have a high level of expertise and skill to create highly effective ... criteria/InterQual Guidelines) to assure quality care is being provided to the patient, in the ...
RN Care Coordinator
Grosse Pointe, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Grosse Pointe, MI · On-site
Responsible for managing a case load of patients that includes facilitating utilization management ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator Rehab inpatient
Taylor, MI · On-site
$34.50 - $41.75/hr
Candidate will function as a Case Management educator and also be expected to provide coverage at ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator Rehab inpatient
Taylor, MI · On-site
$34.50 - $41.75/hr
Candidate will function as a Case Management educator and also be expected to provide coverage at ... May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved ...
RN Care Coordinator
Royal Oak, MI · On-site
... InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when ... Uses defined resources to guide decisions, including Medical Director Care Management, Physician ...
RN Care Coordinator
Royal Oak, MI · On-site
... InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when ... Uses defined resources to guide decisions, including Medical Director Care Management, Physician ...
Social Worker MSW
West Branch, MI · On-site
The MSW Case Manager (CM) must have a high level of expertise and skill to create highly effective ... criteria/InterQual Guidelines) to assure quality care is being provided to the patient, in the ...
Social Worker MSW
West Branch, MI · On-site
The MSW Case Manager (CM) must have a high level of expertise and skill to create highly effective ... criteria/InterQual Guidelines) to assure quality care is being provided to the patient, in the ...
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 is a 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:
Registered Nurse-Access Care- Hybrid -36 Hours-Afternoons
Detroit, MI • On-site
Other
Medical, Dental, Vision
Posted 3 days ago
New
Henry Ford Health rating
7.0
Based on 564 frontline employees who took The Breakroom Quiz
416th of 887 rated healthcare providers
Job description
• Position: 36 hours per week
• Shift: Afternoons 12 Hour Shifts
• Every other weekend and Holiday Rotations
• Benefits: Full time benefit package
- MUST be within driving distance of Elijah McCoy building in downtown Detroit for purposes of ongoing training and if internet is down at remote location
GENERAL SUMMARY:
Within the System Capacity Command Center (SC3) at Henry Ford Health, the Access Management Nurse operates under minimal supervision, to review and screen recommended admission cases at Henry Ford Health System Emergency Departments (ED). Utilizes clinical and regulatory knowledge and skills to reduce financial risk and exposure due to inappropriate admissions. Collaborates with ED physicians, attending physicians, and third-party payers regarding initial screening reviews. Facilitates throughput in the most cost-effective manner, through continuous assessments, problem identification, and education.
EDUCATION/EXPERIENCE REQUIRED:
Bachelor's degree in nursing. Three (3) years of clinical experience. Experience facilitating InterQual reviews, admission process preferred. Experience with systems that support patient flow, admission, and transfer preferred. Ability to prioritize, meet deadlines and produce detailed and accurate work. Excellent clinical knowledge and assessment skills to evaluate and prioritize care issues. Ability to assess and handle highly sensitive and confidential matters with considerable discretion and independent judgment. Demonstrated positive work ethic and strong sense of teamwork/problem solving with co-workers. Understanding of Henry Ford Health policies and procedures preferred.
CERTIFICATIONS/LICENSURES REQUIRED:
Licensed as a Registered Nurse in the State of Michigan.
Additional Information
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Organization: Corporate Services
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Department: System Command Center
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Shift: Evening Job
-
Union Code: Not Applicable
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .
Benefits
The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.What Henry Ford Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Henry Ford Health
Sourced by ZipRecruiter
Henry Ford Health provides a full continuum of services from Primary and Preventative care, to Complex and Cpecialty care, Health Insurance, a full suite of home health offerings, Virtual care, Pharmacy, Eye care and other Healthcare retail. It is one of the Nation’s leading Academic Medical Centers, recognized for Clinical excellence in Cancer care, Cardiology and Cardiovascular Surgery, Neurology and Neurosurgery, Orthopedics and Sports medicine, and Multi organ transplants. Consistently ranked among the top five NIH funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of Health Professionals, Henry Ford Health trains more than 4,000 Medical students, Residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan’s largest and most Diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Detroit, MI, US
Year founded
1915