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Interqual Jobs in California (NOW HIRING)

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 patient-centered treatment and transition plans * Coordinate services across multiple disciplines ...

Medlivo

Travel RN Case Manager

Carmichael, CA · On-site

Cerner and InterQual / Skills: Discharge Planning, Utilization Management, Initial Assessments, InterQual Criteria, Care Coordination, Collaboration, Teamwork, Effective Communication, Prioritization ...

Bestica

Travel Case Manager RN

Torrance, CA · On-site

InterQual experience highly preferred 3424501 RN Case Manager - Travel Contract Torrance, California Shift: Day 5x8 (8:00 AM - 4:30 PM) Start Date: September 14, 2026 Requirements Active California R ...

3B Healthcare, Inc.

RN Registered Nurse

Carmichael, CA · On-site

Interqual Weekend Requirement every other depending on staffing. Would be at least one full weekend per month Holidays not required, but will work if they are willing Scrub Color/Uniform business ...

3B Healthcare, Inc.

Registered Nurse RN

Carmichael, CA · On-site

Interqual Weekend Requirement every other depending on staffing. Would be at least one full weekend per month Holidays not required, but will work if they are willing Scrub Color/Uniform business ...

3B Healthcare, Inc.

Registered Nurse RN

Carmichael, CA · On-site

Interqual Weekend Requirement every other depending on staffing. Would be at least one full weekend per month Holidays not required, but will work if they are willing Scrub Color/Uniform business ...

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All JobsInterqual JobsInterqual Jobs in California

Interqual information

See California salary details

$38.5K

$88.3K

$160.9K

How much do interqual jobs pay per year?

As of Sep 5, 2026, the average yearly pay for interqual in California is $88,311.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,700.00 and $103,100.00 per year, depending on experience, location, and employer.

What is an InterQual?

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.

What does someone working with InterQual do?

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 are the key skills and qualifications needed to thrive in the InterQual position?

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 are the most commonly searched types of Interqual jobs in California?

The most popular types of Interqual jobs in California are:

What are popular job titles related to Interqual jobs in California?

For Interqual jobs in California, the most frequently searched job titles are:

What job categories do people searching Interqual jobs in California look for?

The top searched job categories for Interqual jobs in California are:

What cities in California are hiring for Interqual jobs?

Cities in California with the most Interqual job openings:

Interqual jobs near you
Infographic showing various Interqual job openings in California as of August 2026, with employment types broken down into 65% Full Time, 29% Part Time, and 6% Contract. Highlights an 82% In-person, and 18% Remote job distribution, with an average salary of $88,311 per year, or $42.5 per hour.

Registered Nurse - Case Manager (Remote)

Talencia

Torrance, CA • On-site

$65 - $69/hr

Contractor

Re-posted 27 days ago

Job description

Job Title: RN - Case Manager (Remote Appeals)
Duration: 13 Weeks
Schedule: 8:00 AM – 4:30 PM (M-F; 5x8-Hour Days)
Setting: Acute Care – Remote (Appeals Care Management)
Pay Rate: $65/hr (W2) | $69/hr (1099) 
Job Summary:
We are seeking an experienced Registered Nurse – Case Manager for a remote appeals role. This is a 13-week contract position focused on managing appeal reviews for patient care in an acute hospital setting.
The ideal candidate has a strong background in bedside nursing (telemetry, med-surg, SDU/PCU, or ICU) and a minimum of 2 years of acute hospital case management experience. Prior experience with Epic and InterQual is required. MCG (Milliman Care Guidelines) experience is highly preferred.
Key Responsibilities:
  • Conduct and manage clinical appeal reviews for denied hospital admissions and continued stays
  • Use InterQual and/or MCG guidelines to support medical necessity decisions
  • Coordinate with interdisciplinary care teams to ensure safe and timely discharges
  • Navigate CMS and regulatory requirements for appeals and utilization reviews
  • Document cases accurately in Epic and communicate effectively with payers and providers
  • Ensure compliance with HIPAA, DRG coding, CPT billing, NCQA, OSHA, and Joint Commission standards
Requirements:
  • Active California RN license (unencumbered)
  • BLS Certification (required)
  • Minimum 2 years of recent acute case management experience in a hospital setting
  • Prior bedside RN experience in med/surg, telemetry, SDU/PCU, or ICU required
  • Experience with Epic and InterQual (required)
  • Experience with MCG guidelines (preferred)
  • Strong knowledge of CMS regulations, DRG coding, CPT billing, and appeals processes
  • Ability to manage 4–5 appeals per day
  • Excellent written and verbal communication skills
  • Comfortable working independently in a remote setting.