... InterQual #RemoteNurse #ClinicalTraining #MichiganRN #HealthcareJobs #WorkFromHome #HiringNow
... InterQual #RemoteNurse #ClinicalTraining #MichiganRN #HealthcareJobs #WorkFromHome #HiringNow
The nurse will utilize knowledge of Interqual and Epic systems to support clinical decision-making ... Return to Office (RTO) restrictions limit work from home to no more than 7 days. * Dress code ...
The nurse will utilize knowledge of Interqual and Epic systems to support clinical decision-making ... Return to Office (RTO) restrictions limit work from home to no more than 7 days. * Dress code ...
Outpatient UM Coordinator
Sherman Oaks, CA · On-site
$21 - $23/hr
Apply evidence-based clinical criteria (e.g., InterQual, Milliman) to support medical necessity ... Flexible work from home options available.
Quick apply
Outpatient UM Coordinator
Sherman Oaks, CA · On-site
$21 - $23/hr
Apply evidence-based clinical criteria (e.g., InterQual, Milliman) to support medical necessity ... Flexible work from home options available.
Apply nationally recognized guidelines (MCG, InterQual), CMS coverage criteria, and health plan ... of working from home while managing key clinical determinations for a dynamic health plan ...
Quick apply
Apply nationally recognized guidelines (MCG, InterQual), CMS coverage criteria, and health plan ... of working from home while managing key clinical determinations for a dynamic health plan ...
Apply nationally recognized guidelines (MCG, InterQual), CMS coverage criteria, and health plan ... of working from home while managing key clinical determinations for a dynamic health plan ...
Apply nationally recognized guidelines (MCG, InterQual), CMS coverage criteria, and health plan ... of working from home while managing key clinical determinations for a dynamic health plan ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
RN Utilization Management Reviewer
Concord, NC · Remote
$35 - $40/hr
... Home Health (HH) * Applies established criteria (e.g., InterQual and other available guidelines ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...
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 ... Coordinate services across multiple disciplines including DME, SNF, home health, and ambulance ...
Quick apply
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 ... Coordinate services across multiple disciplines including DME, SNF, home health, and ambulance ...
Familiarity with MCG or InterQual guidelines. * Experience providing care for Medicare populations ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
Familiarity with MCG or InterQual guidelines. * Experience providing care for Medicare populations ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
Care Coordinator RN
$45/hr
InterQual, Care Management Policy, Medical Policy and Electronic Desk References to determine the ... from licensed specialists and/or primary care physicians. * IQ criteria are used as a screening ...
Care Coordinator RN
$45/hr
InterQual, Care Management Policy, Medical Policy and Electronic Desk References to determine the ... from licensed specialists and/or primary care physicians. * IQ criteria are used as a screening ...
Familiarity with MCG or InterQual guidelines. * Experience providing care for Medicare populations ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
Familiarity with MCG or InterQual guidelines. * Experience providing care for Medicare populations ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
Familiarity with MCG or InterQual guidelines. * Experience providing care for Medicare populations ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
Familiarity with MCG or InterQual guidelines. * Experience providing care for Medicare populations ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
... InterQual or Milliman for observation. • Works with physicians, nurses, staff, patients, and families to arrange prompt and safe discharge. • Must take telephone orders from physicians changing ...
... InterQual or Milliman for observation. • Works with physicians, nurses, staff, patients, and families to arrange prompt and safe discharge. • Must take telephone orders from physicians changing ...
Basic knowledge of medical necessity criteria such as Milliman Care Guidelines or Interqual ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
Basic knowledge of medical necessity criteria such as Milliman Care Guidelines or Interqual ... Employees who live and work from Home in the state of California, Illinois, Montana, or South ...
... InterQual or Milliman for observation. • Works with physicians, nurses, staff, patients, and families to arrange prompt and safe discharge. • Must take telephone orders from physicians changing ...
... InterQual or Milliman for observation. • Works with physicians, nurses, staff, patients, and families to arrange prompt and safe discharge. • Must take telephone orders from physicians changing ...
This leader is expected to maintain strong relationships with skilled nursing facilities, home ... Assists in providing in-services on CM/InterQual Reviews/UM philosophy, policies, and procedures as ...
This leader is expected to maintain strong relationships with skilled nursing facilities, home ... Assists in providing in-services on CM/InterQual Reviews/UM philosophy, policies, and procedures as ...
From Home Interqual information
See salary details
$16.59 - $20.54
0% of jobs
$20.54 - $24.50
3% of jobs
$24.50 - $28.45
9% of jobs
$29.91 is the 25th percentile. Wages below this are outliers.
$28.45 - $32.41
36% of jobs
The median wage is $32.72 / hr.
$32.41 - $36.36
27% of jobs
$36.54 is the 75th percentile. Wages above this are outliers.
$36.36 - $40.32
12% of jobs
$40.32 - $44.27
6% of jobs
$44.27 - $48.23
4% of jobs
$48.23 - $52.19
1% of jobs
$52.19 - $56.14
1% of jobs
$56.14 - $60.10
1% of jobs
$16
$36
$60
How much do from home interqual jobs pay per hour?
As of Aug 24, 2026, the average hourly pay for from home interqual in the United States is $36.28, according to ZipRecruiter salary data. Most workers in this role earn between $29.81 and $38.22 per hour, depending on experience, location, and employer.
What is a from home InterQual reviewer?
A Work From Home InterQual reviewer is a healthcare professional, often a nurse or clinical reviewer, who evaluates medical cases remotely using the InterQual criteria. InterQual is a set of evidence-based clinical guidelines used to determine the medical necessity and appropriateness of healthcare services. These reviewers assess patient records, treatment plans, and hospital admissions to ensure they meet established standards, helping healthcare organizations with utilization management and compliance. Working from home allows these professionals to perform their duties remotely, often using secure digital platforms.
What are the key skills and qualifications needed to thrive as a from home InterQual reviewer?
To thrive as a Remote InterQual Reviewer, you need a background in nursing or healthcare, strong clinical judgment, and experience with utilization review processes. Familiarity with InterQual criteria software, electronic medical records (EMRs), and relevant certifications such as RN or LPN/LVN are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for this role. These competencies ensure accurate clinical reviews, regulatory compliance, and clear collaboration with healthcare teams in a remote setting.
What are some common challenges faced by from home InterQual reviewers, and how can they be managed effectively?
Remote InterQual reviewers often face challenges such as maintaining consistent communication with healthcare teams, interpreting clinical documentation without direct patient contact, and managing distractions in a home environment. To address these, it’s important to establish a dedicated workspace, use secure collaboration tools for real-time updates, and participate in regular team meetings. Staying organized and following standard review protocols helps ensure accuracy and efficiency while working independently from home.
What is the difference between From Home Interqual vs From Home Utilization Review Nurse?
| Aspect | From Home Interqual | From Home Utilization Review Nurse |
|---|---|---|
| Certifications | Interqual certification, RN license | RN license, Utilization Review certification |
| Work Environment | Remote, healthcare settings | Remote, healthcare facilities or insurance companies |
| Industry Usage | Healthcare, insurance, case management | Healthcare, insurance, case management |
| Primary Focus | Applying Interqual criteria for patient care decisions | Assessing medical necessity for insurance coverage |
From Home Interqual professionals focus on applying Interqual criteria to evaluate patient care, while From Home Utilization Review Nurses assess medical necessity for insurance coverage. Both roles require RN licensure and healthcare knowledge, but Interqual specialists emphasize criteria application, whereas Utilization Review Nurses focus on coverage decisions.
More about From Home Interqual jobs
What cities are hiring for From Home Interqual jobs?
Cities with the most From Home Interqual job openings:
What are the most commonly searched types of Interqual jobs?
The most popular types of Interqual jobs are:
What states have the most From Home Interqual jobs?
States with the most job openings for From Home Interqual jobs include:
What job categories do people searching From Home Interqual jobs look for?
The top searched job categories for From Home Interqual jobs are:
Job description
- Location: Detroit, Michigan
- Type: Contract
- Job #105434
? Remote / Work From Home
? Michigan RN License Required
About the Opportunity
We are seeking an experienced Registered Nurse (RN) to support clinical quality, training, and utilization management initiatives in a fully remote environment. This role is responsible for staff education, quality reviews, audit coordination, training program development, and supporting accreditation and compliance efforts.
The ideal candidate will have a strong background in Care Management, Utilization Management, InterQual/MCG criteria, clinical training, and quality improvement.
Responsibilities
- Educate staff on managed care programs, processes, systems, and departmental procedures.
- Conduct quality reviews and audits of clinical cases.
- Develop, maintain, and update training materials, manuals, and educational resources.
- Mentor and support new hires throughout the onboarding and training process.
- Collaborate with leadership and subject matter experts to identify training needs and resources.
- Educate internal staff and external provider facilities on clinical policies, InterQual criteria, and departmental processes.
- Create and deliver training programs and educational packages.
- Participate in the development, testing, and implementation of new programs and systems.
- Analyze performance data and provide recommendations for improvement.
- Coordinate training logistics, class registration, scheduling, attendance tracking, and system access for new employees.
- Perform and coordinate internal and external audits.
- Support accreditation and regulatory compliance initiatives.
- Serve as a change champion by supporting new processes, systems, and tools.
- Travel occasionally as needed.
- Nursing Diploma or Associate Degree in Nursing required.
- Current, unrestricted Michigan Registered Nurse (RN) license required.
- Minimum 5 years of experience in healthcare-related fields.
- 3 to 5 years of experience in Care Management and/or Utilization Management.
- Strong knowledge of utilization management processes and InterQual and/or MCG criteria.
- Experience conducting clinical quality reviews and audits.
- Excellent written, verbal, analytical, and organizational skills.
- Ability to work independently and manage multiple priorities in a remote environment.
- Bachelor's Degree in Nursing (BSN) or related field.
- Case Management (CM) Certification.
- Experience with clinical training and staff development.
- Microsoft Office Suite (Excel, Word, Teams)
- SharePoint
- Care Advance
- Virtual Desktop Applications (VDA)
- Electronic Health Records
- ICD-10 and CPT Coding
- CMS, NCQA, HIPAA, and other healthcare regulatory requirements
- Clinical assessment and intervention methodologies
- Fully remote opportunity
- Meaningful impact on clinical quality and staff development
- Collaborative healthcare environment
- Opportunity to contribute to training, compliance, and process improvement initiatives
Apply today if you are a Michigan-licensed RN with experience in Care Management, Utilization Management, training, and quality improvement.
#LI-AH1 #INDPRO #RemoteRN #RegisteredNurse #UtilizationManagement #CareManagement #ClinicalQuality #NurseEducator #HealthcareQuality #CaseManagement #InterQual #RemoteNurse #ClinicalTraining #MichiganRN #HealthcareJobs #WorkFromHome #HiringNow
About Epitec
Sourced by ZipRecruiter
Industry
Recruiting and staffing services
Company size
1,001 - 5,000 Employees
Headquarters location
Southfield, MI, US
Year founded
1978