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Interqual Training Operation Jobs (NOW HIRING)

Med-Metrix

Physician Advisor II - Remote

Participates in ongoing training and education related to the Physician Advisor role and ... operations and administrative standards and policies * Familiarity with MCG/InterQual placement ...

Med-Metrix

Physician Advisor II - Remote

Participates in ongoing training and education related to the Physician Advisor role and ... operations and administrative standards and policies * Familiarity with MCG/InterQual placement ...

MJHS

Pre-Authorization Unit Manager

Manhattan, NY

$135K - $150K/yr

... Operations, Customer Service, Claims, Compliance, and Appeals and Grievances departments ... Ensures InterQual (IQ), internal policies and other criteria (NYS DOH, NCD, LCD) are applied ...

Med-Metrix

Physician Advisor - Remote

Participates in ongoing training and education related to the Physician Advisor role and ... operations and administrative standards and policies * Familiarity with MCG/InterQual placement ...

Med-Metrix

Physician Advisor - Remote

Participates in ongoing training and education related to the Physician Advisor role and ... operations and administrative standards and policies * Familiarity with MCG/InterQual placement ...

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Interqual Training Operation information

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How much do interqual training operation jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for interqual training operation in the United States is $19.89, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $25.00 per hour, depending on experience, location, and employer.

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.

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Interqual Training Operation jobs near you
Infographic showing various Interqual Training Operation job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 16% Part Time, and 1% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $41,374 per year, or $19.9 per hour.

Manger Utilization Management & Quality, Peace Hosptial

UofL Health

Louisville, KY • On-site

Other

Posted 15 days ago

Job description

Primary Location:
Peace - Louisville
Address:
2020 Newburg Rd.Louisville, KY 40205
Shift:
First Shift (United States of America)
Job Description Summary:
About UofL Health:
UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehabilitation Institute and Brown Cancer Center.
With more than 12,000 team members-physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals-UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.
Job Description:
Position Summary and Purpose
The Manager of Utilization Management (UM) leads the strategic and operational oversight of utilization review and management across the academic healthcare system. This role ensures appropriate resource utilization, regulatory compliance, and alignment with clinical and financial goals. The Manager collaborates with medical staff, case management, revenue cycle, and IT to optimize care delivery and reimbursement.
Essential Functions:
1. Manage the day-to-day operations of the utilization review staff, including training, performance evaluation, and setting performance standards.
2. Create, implement, and maintain policies and procedures for the UM program, ensuring they align with regulations and organizational goals
3. Analyze UM metrics, identify trends, and prepare reports for senior management or quality improvement committees to guide decision-making and demonstrate the impact of the program.
4. Monitor the clinical review process to ensure patient care is appropriate, effective, and timely, and collaborate with physicians, case management and other professionals to improve utilization.
5. Identify opportunities to enhance the efficiency and accuracy of UM processes, often by working with physician advisors, case management, nursing leadership, and revenue cycle.
6. Ensure the department complies with all applicable state and federal guidelines and manage audits from regulatory agencies or health plans.
7. Provide mentorship, training and performance evaluations.
8. Ensure accurate documentation and data capture for billing and compliance.
9. Facilitate secondary reviews and appeals processes.
10. Performs other duties as assigned.
Other Functions:
• Participate in UM system-wide UM committees and initiatives.
• Analyze utilization trends and recommend process improvements.
• Coordinate certified training programs (e.g., InterQual, MCG).
• Partner with IT to optimize UM-related systems (e.g., EMR, InterQual).
Additional Job Description:
Job Requirements
(Education, Experience, Licensure and Certification)
Education: Bachelor's degree in nursing or related field, master's degree preferred.
License: Active RN license or LCSW required to practice in the state of Kentucky.
Certification: Case/Utilization Management (e.g., ACM, CCM, CMAC).
Experience: Minimum seven years of UM/Case Management experience in an acute care of academic health system. Minimum 4 years leadership experience.
Job Competency:
Knowledge, Skills, and Abilities critical to this role:
• Strategic thinking
• Deep understanding of clinical workflows and regulatory requirements.
• Strong communication and stakeholder engagement skills.
• Data-driven decision-making and continuous improvement mindset.
UofL Health Core Expectation:
At UofL Health, we expect all our employees to live the values of honesty, integrity and compassion and demonstrate these values in their interactions with others and as they deliver excellent patient care by:
• Honoring and caring for the dignity of all persons
• Ensuring the highest quality of care for those we serve
• Working together as a team to achieve our goals
• Improving continuously by listening, and asking for and responding to feedback
• Seeking new and better ways to meet the needs of those we serve
• Using our resources wisely
• Understanding how each of our roles contributes to the success of UofL Health

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