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Hourly Interqual Jobs (NOW HIRING)

NeueHealth

Utilization Management Nurse, LVN/LPN

$26.35 - $39.53/hr

Working knowledge of MCG, InterQual, and NCQA standards Licensures And Certifications * Active and ... A reasonable estimate of the range is $26.35-$39.53 Hourly. Additionally, employees are eligible ...

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Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Applies established criteria (e.g., InterQual and other available guidelines) and employs clinical ... Knowledge of Medicare and Mass health services and benefits Salary: $35.00 - $40.00 Hourly pending ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Applies established criteria (e.g., InterQual and other available guidelines) and employs clinical ... Knowledge of Medicare and Mass health services and benefits Salary: $35.00 - $40.00 Hourly pending ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Applies established criteria (e.g., InterQual and other available guidelines) and employs clinical ... Knowledge of Medicare and Mass health services and benefits Salary: $35.00 - $40.00 Hourly pending ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Applies established criteria (e.g., InterQual and other available guidelines) and employs clinical ... Knowledge of Medicare and Mass health services and benefits Salary: $35.00 - $40.00 Hourly pending ...

Mission Hospital

RN Case Manager Weekend Plan

Aurora, CO · On-site

$40.35 - $58.87/hr

Hourly Wage Estimate: $40.35 - $58.87 / hour Learn more about the benefits offered for this job ... Evaluates progression of care using evidence-based tools and approved criteria (InterQual ...

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Hourly Interqual information

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$39K

$89.5K

$163K

How much do hourly interqual jobs pay per year?

As of Aug 16, 2026, the average yearly pay for hourly interqual in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What is an hourly InterQual job?

Hourly Interqual jobs typically involve reviewing and applying InterQual criteria, which are evidence-based clinical guidelines, to determine the appropriate level of care for patients in a healthcare setting. Professionals in these roles, such as nurses or case managers, assess clinical documentation and patient needs on an hourly or shift basis to ensure medical necessity and compliance with regulations. These positions are important in hospitals and insurance companies to support authorization decisions, utilization management, and quality assurance. Hourly Interqual jobs may require experience with clinical review tools, strong critical thinking skills, and a background in nursing or related healthcare fields.

What skills and qualifications are needed to thrive as an InterQual Utilization Review Specialist?

To thrive as an InterQual Utilization Review Specialist, you need a background in nursing or healthcare, strong analytical skills, and knowledge of clinical guidelines, often supported by an RN license or related qualification. Proficiency with InterQual software, electronic medical records (EMRs), and utilization management systems is essential. Attention to detail, critical thinking, and effective communication are important soft skills for evaluating cases and collaborating with care teams. These competencies ensure accurate patient assessments, compliance with regulations, and optimal resource utilization in healthcare settings.

What are common challenges faced by hourly InterQual reviewers when assessing patient cases, and how can they be managed?

Hourly Interqual reviewers often encounter challenges such as interpreting complex clinical data, navigating ambiguous documentation, and ensuring timely reviews to support patient care decisions. Effective communication with clinical staff and ongoing education on Interqual criteria can help address these challenges. Collaborating closely with case managers and physicians also ensures accurate assessments and supports efficient patient throughput.

What is the difference between Hourly Interqual vs Hourly Case Manager?

AspectHourly InterqualHourly Case Manager
CredentialsTypically requires nursing or healthcare certifications, such as RN or LPNRequires nursing, social work, or healthcare-related certifications, such as RN, LCSW, or case management certification
Work EnvironmentHospitals, insurance companies, or healthcare facilities focusing on utilization reviewHospitals, clinics, insurance companies, or community health settings
Employer & Industry UsageUsed mainly for clinical decision support and utilization managementUsed for coordinating patient care, discharge planning, and resource management

Hourly Interqual focuses on clinical criteria for utilization review, while Hourly Case Manager emphasizes patient care coordination and discharge planning. Both roles require healthcare certifications and work in similar environments, but their primary functions differ in clinical decision support versus patient management.

What cities are hiring for Hourly Interqual jobs?

Cities with the most Hourly 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 Hourly Interqual jobs?

States with the most job openings for Hourly Interqual jobs include:

Hourly Interqual jobs near you
Infographic showing various Hourly Interqual job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 54% Full Time, and 45% Part Time. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.

Utilization Review RN - Per Diem*

GEORGIA COMMUNITY SUPPORT AND SOLUT

Gardnerville, NV • On-site

Other

Re-posted 24 days ago

Job description

Utilization Review RN - Per Diem*
*IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15% will be added to the hourly rate. Per diem employees are offered work on an "as-needed" basis.
POSITION SUMMARY:
Performs clinically orientated medical chart reviews and other administrative tasks to meet the requirements of the medical center's utilization review plan, state and federal regulations, insurance company requirements for reimbursement.
POSITION REQUIREMENTS:
Minimum Education
  • A Bachelor's Degree in Nursing preferred; three (3) years of clinical care or nursing experience; OR an equivalent combination of education and experience AND (2) two years' experience Utilization Review.
Certificate Preferred
  • CCM (certification in case management) is preferred.
License Required
  • Must be licensed as a Registered Nurse by the State of Nevada, and remain active with all annual licensing requirements.
Minimum Work Experience
  • Minimum of 1 year of case management or utilization management experience.
  • Knowledge of InterQual or McKesson criteria preferred.
  • Knowledge in conducting a medical record review for medical necessity.
  • Knowledge of basic ICD-10, CPT coding knowledge preferred.
  • Basic knowledge of regulations as set forth by The Centers for Medicare Medicaid Services.
  • Skill in operating a personal computer utilizing a variety of software applications.
  • Strong written and oral communication skills
  • Skill and ability to work independently
POSITION ESSENTIAL FUNCTIONS:
Chart Review
  • Conducts chart review to determine that InterQual-based care criteria is met.
  • Assist in determining if patients are in the correct hospital setting
  • Review elective surgery schedule
  • Review outpatient charts (observation)
  • Obtains appropriate patient records as required by payor agencies and initiates the UR Medical Director as necessary for unwarranted admissions
Hospital Reimbursements
  • Understand and demonstrates the requirements needed to maximize reimbursement to the hospital
  • Assist in obtaining authorizations as needed; including follow-up
  • Respond to insurance providers in a timely and thorough manner
  • Communicates with various hospital departments in a meaningful manner
  • Assists in ensuring appropriate room charges, patient status, discharge disposition, etc.
  • Reviews denials and collaborates on appeals of denials
  • Communicates with HIM staff and resolves discrepancies
Knowledge
  • Condition 44 documentation and requirement; HINN notification letters, ABN-advance beneficiary notice, Important Letter from Medicare, etc
  • Maintains practices consistent with the hospital's utilization review (UR) plan
  • Reviews the plans components and is a member of the utilization review committee
  • Obtains data and statistics addressed in the hospital's UR plan and presents information as needed
  • Ensures appropriate and cost-effective healthcare services to patients
Documentation
  • Demonstrates understanding and supports clinical documentation improvement strategies
  • Ability to efficiently locate priority clinical information in a medical record, and to critically interpret that information as part of a treatment plan.
  • Analyze clinical information to identify areas with potential for documentation improvement
  • Demonstrates collaborative work relationship with coding staff to assure documentation of discharge diagnosis and co-morbidities are complete and accurately reflect the patient's clinical status and care.
  • Demonstrates collaborative work relationship with coding staff to assure documentation of discharge diagnosis and co-morbidities are complete and accurately reflect the patient's clinical status and care.
  • Reviews medical records concurrently, recognizes opportunities for documentation improvement, and follows up with appropriate staff.
  • Facilitates modifications to clinical documentation through collaborative interactions with physicians, nurses, and ancillary staff.

CARSON VALLEY HEALTH IS PROUD TO BE RECOGNIZED AS A FINALIST IN THE
"BEST PLACES TO WORK" - NORTHERN NEVADA, 2021, 2022, 2024, 2025 & 2026!
WE LOOK FORWARD TO WELCOMING YOU TO OUR TEAM!!
Per Diem positions have no guaranteed hours or set schedule. The position will fill in for individuals who take unplanned and/or planned time off.

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