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Manager Interqual Jobs in Riverside, CA (NOW HIRING)

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Manager Interqual information

See Riverside, CA salary details

$22

$46

$72

How much do manager interqual jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for manager interqual in Riverside, CA is $46.27, according to ZipRecruiter salary data. Most workers in this role earn between $37.12 and $53.17 per hour, depending on experience, location, and employer.

How does a Manager Interqual typically collaborate with clinical and administrative teams to ensure effective utilization review?

A Manager Interqual works closely with both clinical staff—such as physicians, nurses, and case managers—and administrative teams to implement and oversee the use of InterQual criteria in utilization review processes. They facilitate training, address questions about criteria application, and help resolve discrepancies between clinical recommendations and insurance requirements. Regular meetings and interdisciplinary rounds are common, ensuring that patient care decisions are well-documented and meet regulatory standards. This collaborative approach helps streamline approvals, reduce denials, and maintain high-quality patient care.

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

AspectManager InterqualClinical Case Manager
CredentialsTypically requires nursing or healthcare management certificationsRequires nursing or social work licensure and clinical experience
Work EnvironmentHealthcare organizations, utilization review departmentsHospitals, insurance companies, community health settings
Primary FocusUtilization management, policy implementation, and compliancePatient advocacy, care coordination, and discharge planning

The Manager Interqual primarily oversees utilization review processes and policy adherence within healthcare organizations, often requiring management experience and specific certifications. In contrast, the Clinical Case Manager focuses on direct patient care, coordinating services, and ensuring appropriate treatment. Both roles are vital in healthcare but serve different functions related to patient care and resource management.

What are the key skills and qualifications needed to thrive as a Manager Interqual, and why are they important?

To excel as a Manager Interqual, you need a solid background in healthcare management, clinical guidelines, and utilization review processes, typically supported by a nursing or clinical degree and relevant experience. Familiarity with InterQual criteria, case management software, and healthcare compliance systems is crucial. Strong leadership, analytical thinking, and effective communication are valuable soft skills for guiding teams and collaborating with diverse stakeholders. These competencies ensure proper application of clinical criteria, optimize resource utilization, and support quality patient care and regulatory compliance.

What are Manager Interqual?

A Manager Interqual is a healthcare management professional responsible for overseeing the use and implementation of the InterQual criteria within a healthcare organization. InterQual is a set of evidence-based clinical decision support tools used to ensure appropriate hospital admissions, continued stays, and other medical services. The Manager Interqual leads teams that review cases for medical necessity, ensures compliance with regulatory requirements, and collaborates with clinical staff to optimize patient care and resource utilization. They also provide training on InterQual standards and help integrate these criteria into hospital processes.
Manager Interqual jobs near you

Manager Case Management

Amaya Staffing Consultants LLC

Anaheim, CA

$140K - $214K/yr

Full-time

Re-posted 17 days ago

Job description


Job Title: Manager Case Management

Location: On-site, near Anaheim, CA

Salary Range: $140,000 - $214,000 + Relocation Assistance

Schedule: Full-Time – Admin Hours – Rotating Weekends


Company Information:


Our client is a respected hospital committed to delivering exceptional, patient-centered care in the community. They are currently seeking a full-time, permanent Manager for Case Management to join their dynamic team. This is a fantastic opportunity for a seasoned professional to lead and shape the case management department while contributing to the hospital’s overall success.


Job Summary:


We are looking for an experienced and motivated Manager Case Management to oversee and coordinate case management operations at an acute care facility. This role requires strong leadership skills and comprehensive knowledge of case management protocols and healthcare reimbursement systems.


Key Responsibilities:


  • Provide leadership and direction to the case management department.
  • Ensure compliance with federal and non-federal program rules and regulations regarding case management.
  • Develop and implement department policies and procedures to enhance patient care and efficiency.
  • Oversee staff training and development, fostering a collaborative and high-performing team.
  • Review and analyze case management practices, ensuring alignment with hospital goals and industry standards.
  • Maintain working knowledge of InterQual and Milliman & Robertson criteria.
  • Collaborate with interdisciplinary teams to address patient needs effectively.
  • Manage hospital reimbursement strategies across payers, including Medicare, Medi-Cal, Managed Care, and private insurance plans.


What Qualifications You Will Need:


  • Bachelor’s Degree in Nursing (BSN) required; Master’s Degree (MSN) preferred.
  • Current California Licensed Registered Nurse (RN) certification.
  • Minimum of 5 years of case management experience in an acute care hospital setting or nursing management experience in such environments.
  • In-depth knowledge of case management principles as defined by federal and non-federal programs.
  • Proficiency in using InterQual and M&R guidelines.
  • Solid understanding of hospital reimbursement mechanisms for various payer types.


Apply here today and send your resume to alex@amayastaffing.com