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Manager Interqual Jobs in Washington (NOW HIRING)

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Manager Interqual information

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.

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 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 the difference between Manager Interqual vs Clinical Case Manager?

AspectManager InterqualClinical Case Manager
CredentialsTypically requires nursing or healthcare management certificationsRequires nursing or social work licensure and clinical experience
Work EnvironmentHealthcare organizations, utilization review departmentsHospitals, insurance companies, community health settings
Primary FocusUtilization management, policy implementation, and compliancePatient 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 most commonly searched types of Interqual jobs in Washington?

The most popular types of Interqual jobs in Washington are:

Infographic showing various Manager Interqual job openings in Washington as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Daytime Hospitalist - MedStar Georgetown University Hospital

MedStar Health

Washington, DC • On-site

$255K - $285K/yr

Other

Re-posted 28 days ago


Medstar Health rating

7.8

Company rating: 7.8 out of 10

Based on 240 frontline employees who took The Breakroom Quiz

128th of 887 rated healthcare providers


Job description

Daytime Hospitalist - MedStar Georgetown University Hospital

We are seeking a Daytime Hospitalist to join our Hospital Medicine team at MedStar Georgetown University Hospital in Washington, D.C.

Provides internal medicine care 12 hours per day 7 days per week in all areas of the hospital including but not limited to management of inpatient referrals from primary care physicians (PCP) and the Primary Care Center (PCC) Emergency Department (ED) admissions and consultations inpatient internal medicine care and inpatient medical consultation on other adult patients. Participates as a faculty member in the Internal Medicine Residency program ("Residency") and in programs and initiatives that improves.

Primary Duties and Responsibilities

  • Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Core clinical faculty responsibilities to the residency: Participates in Residency curriculum development. Develops and evaluates resident competencies. Participates in resident conferences and another didactic teaching. Faculty advisor to residents as determined by the Residency Program Director. Mentors provides guidance and feedback and monitors resident stress.
  • Core clinical faculty responsibilities to the residency: Teaches and closely oversees resident care of inpatients on the medical units. Responsible for Teaching and Management rounds. Demonstrates knowledge of internal medicine patient care requirements for hospitalized patients. Provides internal medicine care within the inpatient setting to include but not limited to history and physical exams consultative services daily rounding services and discharge planning. Provides medical care that is of high quality as judged by peers.
  • Demonstrates knowledge of Federal and State regulations about accurate patient billing and coding for both professional services and hospital-related charges. Produces reliable and accurate billing records that allow the hospital to correctly bill third-party payors and other consumers of healthcare at the hospital. Cooperates with third-party resource management within the limits of compliance mandates in providing clinical information pertaining to patient condition.
  • Demonstrates knowledge of utilization criteria including but not limited to InterQual criteria for admission and expected length of hospital stay for medical inpatients. Generates length of stay and hospital charges that are on average below that of non-Hospitalist medical peers.
  • Efficiently manages a caseload of 10 or more patients per day. Demonstrates familiarity and ability to expeditiously work up patients allowing efficient use of hospital resources. Performs care within an acceptable period. Responds to referrals by the PCP and ED for patient evaluation in a timely manner facilitating timely movement of patients through direct or ED admission and throughout the hospital continuum.
  • Facilitates communication between the Program and private attendings. Integrates Program into Case Management and physician extender (PA and NP) services.
  • Participates in multidisciplinary quality and service improvement teams. Participates in meetings and on committees and represents the department and hospital in community outreach efforts. Performs other duties as assigned.
  • Utilizes interpersonal skills that facilitate interactions with the patients families peers ancillary staff and consultants. Assures that patients and families are kept informed of the clinical management care plan and clinical outcomes on a regular basis. Communicates with the patient's PCP on a regular basis via phone fax or other electronic means.

Minimal Qualifications

  • License to practice medicine in the State of Maryland

Experience

  • 1-2 years Experience providing internal medicine care preferred

Licenses and Certifications

  • MD - Physician - State Licensure Board certification or eligibility in Internal Medicine or a comparable adult medical specialty required and
  • Fulfills the requirements for medical staff membership at Hospital required

Knowledge Skills and Abilities

  • Leadership educator and marketing skills.
  • Clinical expertise and business acumen.
  • Ability to collaborate with diverse groups of professionals and support staff.
  • Basic computer skills preferred.

This position has a hiring range of USD $255,000.00 - USD $285,000.00 /Yr.


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About Medstar Health

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MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Columbia, MD, US

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