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Manager Interqual Jobs in Riverside, CA (NOW HIRING)

Cynet Health

RN - Case Manager

Irvine, CA

Case Manager RN Job Type: Travel Profession: Registered Nurse Specialty: Case Management Duration ... Epic Documentation Experience, InterQual Criteria Utilization, Care Coordination, Discharge ...

Cynet Health

RN - Case Manager

Irvine, CA

Case Manager RN Job Type: Travel Profession: Registered Nurse Specialty: Case Management Duration ... Epic Documentation Experience, InterQual Criteria Utilization, Care Coordination, Discharge ...

AHMC Healthcare

Case Manager RN

Anaheim Hills, CA

RN Case Manager The RN Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, concurrent stay and readiness for discharge. She/he assures correct level of care: critical ...

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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 Jun 3, 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.

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.

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 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.

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.

Manager Interqual jobs near you
Registered Nurse - Case Manager

Registered Nurse - Case Manager

Apidel Technologies

Irvine, CA

Full-time

Posted 17 days ago

Job description

Case Manager and Utilization Review RN for Cancer Specialty Hospital.
5 years' experience required.
Epic & InterQual documentation; SBAR communication.
Weekends required.
Certifications Required:
BLS; BSN; State License
Skills/Experience Required:
Acute Hospital; Long Term Acute Care/Rehab/Skilled Nursing; Admission Criteria; Care Coordination; Discharge Planning; Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and Denials; UR Concurrent Review; UR Continued Stay Reviews; UR Medical Necessity; UR Retrospective Review; UR Utilize InterQual Criteria; UR Utilize Milliman Guidelines; CMS: Centers for Medicare and Medicaid Services; CPT (Current Procedural Terminology) coding and billing; Department of Health; DRG (Diagnosis Related Groups); HEDIS (The Healthcare Effectiveness Data and Information Set) Measures; HIPAA guidelines (Health Insurance Portability and Accountability Act); ICD 10 Coding; NCQA (National Committee for Quality Assurance); OSHA; The Joint Commission/ Core Measure/National Safety Goals
Workers Compensation


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About Apidel Technologies

Sourced by ZipRecruiter

We understand that attracting, qualifying, placing, and retaining the best candidates for our clients requires exceptional talent. That’s why our highly skilled and dedicated recruitment team works tirelessly to develop lifelong associations with all candidates and clients. We prioritize helping our employees achieve their career goals while providing effective staffing solutions to our clients and candidates. At Apidel, we believe in simple yet established core values that are ingrained within each member of our team. These values are time and again illustrated in our approach to employees, candidates, and clients. Our unwavering belief that our core values of integrity, client satisfaction, innovation, and intellect distinguish us from our competitors is what drives us forward. We remain focused on improving and sustaining a measurable client satisfaction program that has created an organizational culture where our associates provide world-class service every day.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Plainfield, IL, US

Year founded

2012

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