Under the Director of InterQual Clinical Services' direction, the Senior Clinical Education Consultant will provide Clinical Education and Consulting to customers, as assigned, for InterQual Related ...
Under the Director of InterQual Clinical Services' direction, the Senior Clinical Education Consultant will provide Clinical Education and Consulting to customers, as assigned, for InterQual Related ...
Under the Director of InterQual Clinical Services' direction, the Senior Clinical Education Consultant will provide Clinical Education and Consulting to customers, as assigned, for InterQual Related ...
Under the Director of InterQual Clinical Services' direction, the Senior Clinical Education Consultant will provide Clinical Education and Consulting to customers, as assigned, for InterQual Related ...
Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED
San Pedro, CA · On-site
Description Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Discharge Planning Brandon Boughton Call or Text: 570-220-3858 ...
Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED
San Pedro, CA · On-site
Description Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Discharge Planning Brandon Boughton Call or Text: 570-220-3858 ...
Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED
Los Angeles, CA · On-site
Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Discharge Planning Brandon Boughton Call or Text: 570-220-3858 linkedin.com ...
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Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED
Los Angeles, CA · On-site
Travel RN Case Manager - San Pedro, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Discharge Planning Brandon Boughton Call or Text: 570-220-3858 linkedin.com ...
Description Travel RN Case Manager - Santa Monica, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Care Coordination Brandon Boughton Call or Text: 570-220-3858 ...
Description Travel RN Case Manager - Santa Monica, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Care Coordination Brandon Boughton Call or Text: 570-220-3858 ...
Travel RN Case Manager - Santa Monica, CA | 5x8 Days | Acute Care | InterQual REQUIRED
Santa Monica, CA · On-site
Travel RN Case Manager - Santa Monica, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Care Coordination Brandon Boughton Call or Text: 570-220-3858 linkedin ...
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Travel RN Case Manager - Santa Monica, CA | 5x8 Days | Acute Care | InterQual REQUIRED
Santa Monica, CA · On-site
Travel RN Case Manager - Santa Monica, CA | 5x8 Days | Acute Care | InterQual REQUIRED Case Management | Utilization Review | Care Coordination Brandon Boughton Call or Text: 570-220-3858 linkedin ...
Additional Information All your information will be kept confidential according to EEO guidelines.
Additional Information All your information will be kept confidential according to EEO guidelines.
Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
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Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
Quick apply
Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
Quick apply
Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
Review admissions using InterQual and/or Milliman criteria * Evaluate medical necessity, level of care, and documentation accuracy * Ensure compliance with Medicare, Medicaid, and regulatory ...
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Review admissions using InterQual and/or Milliman criteria * Evaluate medical necessity, level of care, and documentation accuracy * Ensure compliance with Medicare, Medicaid, and regulatory ...
Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
Quick apply
Epic & InterQual documentation; SBAR communication. Weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab/Skilled ...
Epic & InterQual documentation; SBAR communication. Rotating weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab ...
Quick apply
Epic & InterQual documentation; SBAR communication. Rotating weekends required. Certifications Required: BLS; BSN; State License Skills/Experience Required: Acute Hospital; Long Term Acute Care/Rehab ...
Review admissions using InterQual and/or Milliman criteria * Evaluate medical necessity, level of care, and documentation accuracy * Ensure compliance with Medicare, Medicaid, and regulatory ...
Review admissions using InterQual and/or Milliman criteria * Evaluate medical necessity, level of care, and documentation accuracy * Ensure compliance with Medicare, Medicaid, and regulatory ...
RN - Manager of Clinical Access Case Manager (Days)
Farmington, NM · On-site
$31 - $46.50/hr
The nurse in this role applies InterQual criteria and utilization review and management principles across all patient populations to support appropriate admission status, care transitions, and ...
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RN - Manager of Clinical Access Case Manager (Days)
Farmington, NM · On-site
$31 - $46.50/hr
The nurse in this role applies InterQual criteria and utilization review and management principles across all patient populations to support appropriate admission status, care transitions, and ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Case Manager, RN - Case Management - Per Diem 8 Hour Days (Non-Exempt) (Union)
Los Angeles, CA · On-site
$47.31 - $100/hr
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Case Manager, RN - Case Management - Per Diem 8 Hour Days (Non-Exempt) (Union)
Los Angeles, CA · On-site
$47.31 - $100/hr
Participates in InterQual competency testing as requested by department director. * Outcomes Management Participates in core measure process in identification of appropriate patients. Participates in ...
Interqual information
See salary details
$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
How much do interqual jobs pay per year?
What jobs pay 2000 a day?
What are the typical daily responsibilities of someone working with InterQual criteria in a healthcare setting?
Professionals utilizing InterQual criteria are primarily responsible for reviewing medical records and assessing whether inpatient admissions, procedures, or continued stays meet established clinical guidelines. Daily tasks often include documenting findings, communicating with physicians and care teams to clarify case details, and collaborating with insurance companies regarding authorization of services. These professionals act as a key resource for ensuring compliance with industry standards and optimizing patient care pathways. Successful InterQual specialists proactively identify discrepancies and help resolve issues that might delay care or reimbursement. You can expect regular interaction with both clinical and administrative staff in a fast-paced healthcare environment.
What jobs pay $10,000 a month without a degree?
What are the key skills and qualifications needed to thrive in the Interqual position, and why are they important?
To excel in a role focused on InterQual, such as an InterQual Specialist or Utilization Review Nurse, you need a strong background in healthcare, clinical assessment skills, and familiarity with utilization management. Proficiency in using InterQual software, electronic health records (EHRs), and knowledge of medical necessity criteria are essential, and certification in case management or utilization review is often preferred. Attention to detail, strong analytical thinking, and effective communication are critical soft skills for this position. These skills ensure accurate case evaluations, appropriate care decisions, and efficient collaboration with healthcare providers and payer organizations.
What does InterQual do?
What is the least stressful healthcare job?
What is an InterQual job?
An InterQual job typically involves using InterQual criteria—a set of evidence-based guidelines—to assess medical necessity for healthcare services. Professionals in these roles, such as nurses or case managers, review patient cases to ensure treatments align with best practices and insurance requirements. They work in hospitals, insurance companies, or healthcare organizations to support utilization management and improve patient care efficiency. Strong clinical knowledge and familiarity with InterQual software are often required for these positions.
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Full-time
Retirement
Posted 9 days ago
Key responsibilities
Prepares for and delivers education over multiple InterQual products, programs, services, and applications to clients.
Collaborates with internal teams and clients to update curriculum and provide feedback for improved customer experience and software implementations.
Documents each education session conducted within the identified timeframe to ensure complete and concise records of services provided.
UnitedHealth Group rating
7.6
Based on 145 frontline employees who took The Breakroom Quiz
188th of 877 rated healthcare providers
Job description
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Optum, part of UnitedHealth Group (NYSE: UNH), is a leading information, technology-enabled health services, and software business dedicated to helping make the health system work better for everyone. We work with governments, employers, partners, and providers to care for over 146 million people and share a vision of a value-based system of care that provides compassionate and equitable care. With more than 190,000 people worldwide, Optum delivers intelligent, integrated solutions that help to modernize the health system and improve overall population health.
At Optum Insight (OI), we champion continuous innovation to provide software, network, and data analytics, technology-enabled services, advisory, and revenue cycle management offerings to help make health care work better for everyone.
UnitedHealthcare offers a full range of health benefits, enabling affordable coverage, simplifying the health care experience, and delivering access to high quality care. Our mission calls us, our values guide us, and our diverse culture connects us as we seek to improve care for the consumers we are privileged to serve and their communities.
Under the Director of InterQual Clinical Services' direction, the Senior Clinical Education Consultant will provide Clinical Education and Consulting to customers, as assigned, for InterQual Related Products, Programs and Platforms.
The Senior Clinical Education Consultant interacts with appropriate internal and external contacts to ensure program coordination and knowledge of customer business and InterQual education needs.
The Senior Clinical Education Consultant will provide education on services that will include IQCI, IQCER and RM Implementations clients, including InterQual Customize and or Coordinated Care as contracted.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
- Customer Education and Consulting Services
- Prepares for and delivers education over multiple InterQual products, programs, services, and applications and helps integrate customer workflow or business processes with product functionality
- Delivery of client education on all InterQual products, programs, and professional education courses. Programs will Include: InterQual Certified Instructor, InterQual Certified Expert Resource, Review Manager Implementations
- Delivery of programs as an extension of the customer experience team include InterQual Customize and Coordinated Care
- Works closely with Client Learning and Development team to update curriculum for specialized services noted above annually or more frequently if needed
- Provides customized customer mentoring services to enhance the educational experience
- Collaborates with Services, Product and Project Management and Technical teams to provide feedback for improved Customer experience, software, implementations, etc.
- Consults with clients on InterQual education best practices, may require accessing customer system
- Leverages cross-functional teams to identify issues and develop InterQual solutions that meet operational and customer objectives
- Solves complex education issues as a subject matter expert
- Documents each education session conducted within identified timeframe, ensuring notes are complete and concise, this ensures the organization can review services that were provided within the education department
- Exercises independent judgment in developing methods, techniques, and evaluation criteria for obtaining results
- Development and Maintenance of InterQual Programs and Services
- Assists in defining new service offerings working closely with the Director of InterQual Clinical Services Assists in the development of new programs and education delivery methods for all software programs that deliver InterQual
- Exercises independent judgment in developing methods, techniques, and evaluation criteria for result oriented outcomes
- Provides recommendations for new InterQual education materials that contain complex subject matter in conjunction with product management, software engineering or technical writers
- Assists in developing and maintaining, InterQual education materials as assigned (case studies, competency exams/quizzes and/or exercises) to augment education sessions including education materials, and internal and external InterQual Toolkit
- Coordinate updates to Client Learning and Development as needed to ensure education materials are up to date with content releases
- Review of assigned InterQual IRR and or IQCI tests with direction from Clinical Quality Specialist, on an ongoing basis to ensure accuracy with updates from Clinical Development
- Working with designated team members to develop and present materials for "Increase Your IQ" webinars as assigned
- Maintains internal working relationships to understand evolution of features/functionality for new releases or enhancements
- Maintaining and updating InterQual Programs and Services
- Working closely with the Client Learning and Development team to develop new education materials including new case studies
- Assists and coordinates material updates to ensure accurate material use for internal and external education sessions, including IQCI, IQCER, Customization and Coordinated care
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Bachelor's degree in health care management field
- Registered Professional Nurse with Active License
- 6 years of experience in utilization review/management, case management and or care management
- 4 years of experience in adult education/training including presenting materials to varied groups of participants
- Experience with InterQual Criteria
- Experience in healthcare hospital and or payer-based software
- Proven ability to effectively communicate with clinical, technical, and business staff
- Proven consultative thought process and approach to customer issues
- Ability to work well within a fast-paced, team- oriented environment. Willingness and ability to travel as required
- Potential for travel approximately 20% of the time
Preferred Qualifications:
- BSN
- Bilingual in Spanish
- Advanced experience with applicable tools (e.g., MS Office suite, LiveMeeting/Zoom/Webex, etc.)
- In-depth knowledge of technical training
- Advanced knowledge of product and technical details
- Knowledge of industry or industry background required (e.g., clinical)
- Proven Presentation and Training skills
- Proven ability to work independently within the role, taking on the responsibility of providing education daily
- Demonstrates a solid clinical background and Critical thinking skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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About UnitedHealth Group
Sourced by ZipRecruiter
Industry
Insurance services
Company size
10,000+ Employees
Headquarters location
Minnetonka, MN, US
Year founded
1977