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.
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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.
... InterQual Criteria accurately in conjunction with the UR Department workflows/processes, clinical ... Work Type: This position is a remote position outside traditional office, often from home or ...
... InterQual Criteria accurately in conjunction with the UR Department workflows/processes, clinical ... Work Type: This position is a remote position outside traditional office, often from home or ...
Clinical Systems Trainer RN
OR · Remote
... InterQual); they author guidelines from regulatory requirements or customize from nationally ... NOTE: This position is work from home, but you must reside in Oregon or SW WA. The schedule is ...
Clinical Systems Trainer RN
OR · Remote
... InterQual); they author guidelines from regulatory requirements or customize from nationally ... NOTE: This position is work from home, but you must reside in Oregon or SW WA. The schedule is ...
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 ...
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 ...
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
$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 ...
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 ...
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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 ...
Medical Director Medicaid
Danville, PA · On-site +1
Work from home (Pennsylvania) Shift: Rotation (United States of America) Scheduled Weekly Hours: 40 ... Familiarity with InterQual/MCG criteria and care management platforms; comfort using data to guide ...
Medical Director Medicaid
Danville, PA · On-site +1
Work from home (Pennsylvania) Shift: Rotation (United States of America) Scheduled Weekly Hours: 40 ... Familiarity with InterQual/MCG criteria and care management platforms; comfort using data to guide ...
... 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 ...
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 ...
RN Case Manager
East Liverpool, OH · On-site
Ohio Valley Home Health is affiliated with East Liverpool City Hospital, one of the nation's "100 ... the facility from the point of their admission and across the continuum of the health care ...
RN Case Manager
East Liverpool, OH · On-site
Ohio Valley Home Health is affiliated with East Liverpool City Hospital, one of the nation's "100 ... the facility from the point of their admission and across the continuum of the health care ...
RN Case Manager
East Liverpool, OH · On-site
Ohio Valley Home Health is affiliated with East Liverpool City Hospital, one of the nation's "100 ... Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment StatusFull ...
RN Case Manager
East Liverpool, OH · On-site
Ohio Valley Home Health is affiliated with East Liverpool City Hospital, one of the nation's "100 ... Knowledge of Milliman Criteria and InterQual Criteria preferred. LI-HMI Employment StatusFull ...
Case Management Manager
Lebanon, TN · On-site
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability ... Ensure staff are competent in the use of InterQual to progress the plan of care. * Work ...
Case Management Manager
Lebanon, TN · On-site
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability ... Ensure staff are competent in the use of InterQual to progress the plan of care. * Work ...
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 4, 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 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.
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 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.
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
Job Summary:
The Registered Nurse - Case Manager provides skilled nursing care and case management within an acute care facility, ensuring high-quality patient outcomes. This role requires current acute hospital experience and involves patient assessments, care planning, medication administration, and collaboration with interdisciplinary teams. The nurse will utilize knowledge of Interqual and Epic systems to support clinical decision-making and documentation while adhering to department standards and policies.
Responsibilities:
Required Skills & Certifications:
The Registered Nurse - Case Manager provides skilled nursing care and case management within an acute care facility, ensuring high-quality patient outcomes. This role requires current acute hospital experience and involves patient assessments, care planning, medication administration, and collaboration with interdisciplinary teams. The nurse will utilize knowledge of Interqual and Epic systems to support clinical decision-making and documentation while adhering to department standards and policies.
Responsibilities:
Required Skills & Certifications:
- Active California Registered Nurse license (pending licenses accepted).
- Minimum of 6 months current acute hospital nursing experience.
- Proficiency with Interqual criteria and Epic electronic health record system.
- Strong clinical assessment, medication administration, and care planning skills.
- Excellent communication and interdisciplinary collaboration abilities.
- Ability to manage a patient ratio of approximately 1:20.
- Prior experience in case management within an acute care setting.
- Familiarity with hospital utilization review processes and criteria.
- Experience working with diverse patient populations in fast-paced environments.
- Weekend shifts required at least 2 per 4-week schedule to meet staffing needs.
- Return to Office (RTO) restrictions limit work from home to no more than 7 days.
- Dress code requires business casual or dark solid scrubs with lab coat.
- Shift assignments include weekdays and mandatory weekend coverage.
- Schedules are designed to maintain appropriate nurse-to-patient ratios and meet department demands.
About vTech Solution
Sourced by ZipRecruiter
vTech is a Managed IT Services firm based out of Washington DC with a primary focus on Cloud Computing and Managed Network Security.
Industry
It services
Company size
51 - 200 Employees
Headquarters location
Washington, DC, US
Year founded
2006