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From Home Interqual Jobs (NOW HIRING)

Sagility

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 ...

Sagility LLC

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 ...

Sagility LLC

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 ...

Sagility LLC

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 ...

Sagility LLC

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 ...

Sagility

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 ...

Dane Street, LLC

Utilization Review Physician

InterQual * MCG * CMS guidelines (including 2-Midnight Rule) * LCD/NCD * Client-specific policies ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...

Talencia

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 ...

Geisinger Health

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 ...

Humana, Inc.

Medical Director - Claims

Experience with national guidelines such as MCG ® or InterQual * Internal Medicine, Family ... Associates who live and work from Home in the state of California, Illinois, Montana, or South ...

Ephraim McDowell Health

Nurse Case Manager

Danville, KY · On-site

Appropriately assign the status of inpatient versus observation based on InterQual criteria from ... During home visits possible exposure to disease, infection and physical strain and assault, as well ...

Ephraim McDowell Health

Nurse Case Manager

Danville, KY · On-site

Appropriately assign the status of inpatient versus observation based on InterQual criteria from ... During home visits possible exposure to disease, infection and physical strain and assault, as well ...

Dane Street, LLC

Quality Analyst (Remote, LPN Required)

$45K - $70K/yr

... InterQual, or health plan specific guidelines/criteria). * Examine and evaluate patient records to ... WORK FROM HOME TECHNICAL REQUIREMENTS: Supply and support their own internet services. Maintaining ...

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All JobsInterqual JobsFrom Home Interqual Jobs

From Home Interqual information

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$16

$36

$60

How much do from home interqual jobs pay per hour?

As of Jul 13, 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?

AspectFrom Home InterqualFrom Home Utilization Review Nurse
CertificationsInterqual certification, RN licenseRN license, Utilization Review certification
Work EnvironmentRemote, healthcare settingsRemote, healthcare facilities or insurance companies
Industry UsageHealthcare, insurance, case managementHealthcare, insurance, case management
Primary FocusApplying Interqual criteria for patient care decisionsAssessing 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 Remote InterQual Reviewer, and why are they important?

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 remote 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 Work 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:
From Home Interqual jobs near you
Infographic showing various From Home Interqual job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 71% Full Time, 23% Part Time, 1% Temporary, and 4% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $75,459 per year, or $36.3 per hour.
Registered Nurse Case Manager

Registered Nurse Case Manager

vTech Solution

Santa Monica, CA • On-site

Other

Re-posted 8 days ago

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:
  • 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.
Preferred Skills & Certifications:
  • 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.
Special Considerations:
  • 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.
Scheduling:
  • Shift assignments include weekdays and mandatory weekend coverage.
  • Schedules are designed to maintain appropriate nurse-to-patient ratios and meet department demands.
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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

Social media

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