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Interqual Training Operation Jobs in Virginia (NOW HIRING)

UVA Health

Physician Advisor (Remote)

Manassas, VA · Remote

$250K - $350K/yr

... operational outcomes. Join a dedicated and collaborative team that is valued by health system ... Perform medical necessity reviews using MCG and/or InterQual * Support CMS compliance, including ...

Sentara Health

Anesthesiology Physician

Suffolk, VA · On-site

$380K/yr

Complete required training and continuing education. * Support additional responsibilities as ... Regulations, InterQual, MCG, DRG, Hospital Operations, Medical Staff Engagement, Healthcare ...

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Interqual Training Operation information

What is Interqual Training Operation?

Interqual Training Operation refers to the processes and programs designed to educate healthcare professionals on using InterQual criteria, which are evidence-based clinical decision support tools. These trainings help users understand how to apply InterQual guidelines for patient admissions, continued stays, and discharge decisions. Effective Interqual Training Operation ensures staff are proficient in utilizing the software and criteria to promote appropriate care and compliance with regulations. The training may include online modules, in-person sessions, and ongoing support to address updates and best practices.

What are the key skills and qualifications needed to thrive in Interqual Training Operations?

To excel in Interqual Training Operations, you need a strong understanding of clinical guidelines, healthcare utilization management, and experience with InterQual criteria, typically supported by a background in nursing or healthcare administration. Familiarity with InterQual software, learning management systems (LMS), and relevant certifications such as RN or case management credentials is crucial. Excellent communication, instructional skills, and attention to detail help trainers effectively educate teams and ensure compliance. These skills are vital for ensuring accurate application of clinical guidelines, improving patient outcomes, and maintaining regulatory standards.

What are the main challenges faced by professionals working in Interqual Training Operations, and how can they be addressed?

Professionals in Interqual Training Operations often encounter challenges such as staying current with evolving clinical guidelines and ensuring consistent training across diverse healthcare teams. Addressing these challenges involves regularly updating training materials, fostering strong communication with clinical staff, and leveraging feedback to improve training sessions. Collaboration with both clinical experts and IT teams is crucial to ensure that Interqual criteria are implemented effectively and understood organization-wide. Continuous professional development and adaptability are key to success in this dynamic environment.

What is the difference between Interqual Training Operation vs Interqual Clinical Reviewer?

AspectInterqual Training OperationInterqual Clinical Reviewer
CredentialsTypically requires training certifications in utilization management and Interqual softwareRequires clinical licenses (RN, MD, or other healthcare credentials) and familiarity with Interqual criteria
Work EnvironmentTraining sessions, administrative settings, healthcare organizationsClinical settings, hospitals, insurance companies, utilization review departments
Employer & Industry UsageHealthcare organizations, training providers, health plansInsurance companies, healthcare providers, utilization review agencies

Interqual Training Operations focus on delivering training and managing Interqual software, while Interqual Clinical Reviewers evaluate patient cases using Interqual criteria to determine care appropriateness. Both roles require familiarity with Interqual but differ in responsibilities and credentials.

What are popular job titles related to Interqual Training Operation jobs in Virginia?

For Interqual Training Operation jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Interqual Training Operation jobs in Virginia look for?

The top searched job categories for Interqual Training Operation jobs in Virginia are:

What cities in Virginia are hiring for Interqual Training Operation jobs?

Cities in Virginia with the most Interqual Training Operation job openings:

Interqual Training Operation jobs near you
Infographic showing various Interqual Training Operation job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Physician Advisor (Remote)

UVA Health Northern VA & Culpeper

Manassas, VA • On-site, Remote

$250K - $350K/yr

Full-time

Posted 14 days ago

Job description


Physician Advisor (Remote)
Opportunity
UVA Health is seeking an experienced Physician Advisor to provide physician leadership across Utilization Management (UM), Clinical Documentation Integrity (CDI), Coding, and Case Management. This remote role focuses on medical necessity, regulatory compliance, documentation improvement, and advancing quality and operational outcomes. Join a dedicated and collaborative team that is valued by health system leadership for this unique skillset.
Key Responsibilities
  • Perform medical necessity reviews using MCG and/or InterQual
  • Support CMS compliance, including the 2-Midnight Rule and inpatient status determinations
  • Partner with Case Management, CDI, and physician teams to improve documentation and patient flow
  • Provide physician education, documentation feedback, and CDI query support
  • Conduct peer-to-peer reviews and assist with denial prevention and appeals
  • Participate in quality, compliance, and operational improvement initiatives

Position Highlights
  • Fully remote physician leadership opportunity (with the exception of 4 on-site meetings per year that are 1-day meetings)
  • Collaborate with multidisciplinary teams across UVA Health
  • Improve clinical documentation, utilization practices, and patient outcomes
  • Help shape system-wide initiatives in quality, compliance, and stewardship

Qualifications
  • MD or DO
  • Board Certified in Family Medicine, Internal Medicine or Pediatrics
  • Eligible for Virginia medical licensure
  • Prior Utilization Management experience preferred
  • Knowledge of CMS regulations and MCG/InterQual guidelines
  • Excellent communication and collaboration skills

The base compensation range for this role is $250,000 - $350,000 for a 1.0 clinical FTE status.
Individual compensation will be determined by fair market value and the selected candidate's qualifications, clinical experience, specialty training, credentials, and/or education. Please note that the pay range does not include any applicable incentive compensation programs, such as productivity, quality, non-productivity, or other incentives that may be available for eligible positions.
We are equal opportunity employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex, pregnancy, sexual orientation, veteran or military status, and family medical or genetic information.

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