... decision support criteria (InterQual Intensity of Service, Severity of Illness criteria ... Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload
... decision support criteria (InterQual Intensity of Service, Severity of Illness criteria ... Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload
Registered Nurse (RN) - Hiring Now!
Riverside, CA · On-site
$64 - $91/hr
Acute care/inpatient case management experience required. * InterQual experience preferred Founded in 1901, Riverside Community Hospital is a 542-bed full-service acute care hospital. We are in the ...
Registered Nurse (RN) - Hiring Now!
Riverside, CA · On-site
$64 - $91/hr
Acute care/inpatient case management experience required. * InterQual experience preferred Founded in 1901, Riverside Community Hospital is a 542-bed full-service acute care hospital. We are in the ...
Manager Interqual information
See Riverside, CA salary details
$22.07 - $26.67
2% of jobs
$26.67 - $31.28
6% of jobs
$31.28 - $35.89
13% of jobs
$36.84 is the 25th percentile. Wages below this are outliers.
$35.89 - $40.49
19% of jobs
The median wage is $43.06 / hr.
$40.49 - $45.10
18% of jobs
$45.10 - $49.70
15% of jobs
$50.85 is the 75th percentile. Wages above this are outliers.
$49.70 - $54.31
9% of jobs
$54.31 - $58.91
6% of jobs
$58.91 - $63.52
4% of jobs
$63.52 - $68.12
4% of jobs
$68.12 - $72.73
3% of jobs
$22
$46
$72
How much do manager interqual jobs pay per hour?
As of Jun 29, 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?
| Aspect | Manager Interqual | Clinical Case Manager |
|---|---|---|
| Credentials | Typically requires nursing or healthcare management certifications | Requires nursing or social work licensure and clinical experience |
| Work Environment | Healthcare organizations, utilization review departments | Hospitals, insurance companies, community health settings |
| Primary Focus | Utilization management, policy implementation, and compliance | Patient 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.
RN Case Manager EX - Case management - Days - FT - Orange
Orange, CA • On-site
Other
Medical, Retirement, PTO
Posted 13 days ago
University Of California Irvine rating
8.7
Based on 40 frontline employees who took The Breakroom Quiz
44th of 541 rated colleges and universities
Job description
Who We Are
UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.
To learn more about UCI Health, visit www.ucihealth.org.
Your Role on the Team
Position Summary:
Incumbent is responsible for a high level assessment and reassessment process for the patient/family to set priorities, plan, organize, and implement care that is goal-directed toward self-care outcomes. Collaborates with an interdisciplinary approach to care facilitation to promote and coordinate the delivery of high quality, individualized, safe and cost-effective patient care, and transitions of care. Advocates for patient self-determination and choice. Practices cultural competence in evaluations and planning with awareness and respect for patient and family diversity. Monitors and coordinates resource utilization throughout the health system and evaluates services provided. Performs the appropriate utilization review functions utilizing medical staff-approved decision support criteria (InterQual Intensity of Service, Severity of Illness criteria). Concurrently intervenes to enhance patient quality outcomes where appropriate. Ensures clinical information in the medical record is clear and complete reflecting the patient's true severity of illness through interfacing with physicians to improve the overall quality of the clinical documentation.
What It Takes to be Successful
Required Qualifications:
We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.
Conditions of Employment:
The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:
The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.
Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php
Closing Statement:
The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.
We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.
UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m.
Consideration for Work Authorization Sponsorship
Must be able to provide proof of work authorization
UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.
To learn more about UCI Health, visit www.ucihealth.org.
Your Role on the Team
Position Summary:
Incumbent is responsible for a high level assessment and reassessment process for the patient/family to set priorities, plan, organize, and implement care that is goal-directed toward self-care outcomes. Collaborates with an interdisciplinary approach to care facilitation to promote and coordinate the delivery of high quality, individualized, safe and cost-effective patient care, and transitions of care. Advocates for patient self-determination and choice. Practices cultural competence in evaluations and planning with awareness and respect for patient and family diversity. Monitors and coordinates resource utilization throughout the health system and evaluates services provided. Performs the appropriate utilization review functions utilizing medical staff-approved decision support criteria (InterQual Intensity of Service, Severity of Illness criteria). Concurrently intervenes to enhance patient quality outcomes where appropriate. Ensures clinical information in the medical record is clear and complete reflecting the patient's true severity of illness through interfacing with physicians to improve the overall quality of the clinical documentation.
What It Takes to be Successful
Required Qualifications:
- Minimum 5 years of clinical experience and 1 year of previous Case Management experience or a UCI employee who meets the clinical requirements and has a BSN.
- Familiarity of Joint Commission, CMS, CDPH and CCS requirements
- Excellent written and verbal communication skills in English
- Current RN License
- Computer literacy and proficiency
- All external candidates must have a Bachelor of Science in Nursing
- Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload
- Ability to facilitate and lead interdisciplinary rounds
- Ability to establish and maintain effective working relationships across the Health System
- Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties
- Must possess complete understanding of acuity levels for specific patient population
- Must demonstrate customer service skills appropriate to the job
- Knowledge of University policies and procedures
- Knowledge of California Children's Services benefits authorization process (CCS)
- CCM, ACM or Case Management credentialing
- Bilingual skills
We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.
Conditions of Employment:
The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:
- Background Check and Live Scan
- Employment Misconduct*
- Legal Right to Work in the United States
- Vaccination Policies
- Smoking and Tobacco Policy
- Drug Free Environment
The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.
- California Child Abuse and Neglect Reporting Act
- E-Verify
- Pre-Placement Health Evaluation
Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php
Closing Statement:
The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.
We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.
UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday - Friday from 8:30 a.m. - 5:00 p.m.
Consideration for Work Authorization Sponsorship
Must be able to provide proof of work authorization
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