The ideal candidate will have strong experience in acute inpatient case management, utilization review, InterQual/Milliman guidelines, and complex care coordination within hospital settings. Key ...
The ideal candidate will have strong experience in acute inpatient case management, utilization review, InterQual/Milliman guidelines, and complex care coordination within hospital settings. Key ...
Travel Travel RN - Acute Care Case Manager 📍 Orange CA ⏳ 13-Week Contract 🕒 Day Shift ... Epic & InterQual Experience Preferred Key Responsibilities: • Care Coordination & Discharge ...
New
Travel Travel RN - Acute Care Case Manager 📍 Orange CA ⏳ 13-Week Contract 🕒 Day Shift ... Epic & InterQual Experience Preferred Key Responsibilities: • Care Coordination & Discharge ...
New
Travel Nurse RN - Case Management - $3,101 per week
Irvine, CA · On-site
$3.10K/wk
LanceSoft is seeking a travel nurse RN Case Management for a travel nursing job in Irvine ... Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and ...
New
Travel Nurse RN - Case Management - $3,101 per week
Irvine, CA · On-site
$3.10K/wk
LanceSoft is seeking a travel nurse RN Case Management for a travel nursing job in Irvine ... Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and ...
New
Acute Care Case Management * Discipline: RN * Start Date: 06/16/2026 * Duration: 13 weeks * 40 ... Apply InterQual and Milliman guidelines to support medical necessity determinations * Coordinate ...
New
Acute Care Case Management * Discipline: RN * Start Date: 06/16/2026 * Duration: 13 weeks * 40 ... Apply InterQual and Milliman guidelines to support medical necessity determinations * Coordinate ...
New
In this position the Case Manager, RN will provide utilization education, identification of ... Knowledge and experience with InterQual (CERME) or other national standard. Data Entry skills ...
In this position the Case Manager, RN will provide utilization education, identification of ... Knowledge and experience with InterQual (CERME) or other national standard. Data Entry skills ...
RN - Case Manager
Redlands, CA · On-site
Candidates should be familiar with utilizing InterQual criteria, and comply with CMS and HIPAA ... to manage needs assessments and care plans effectively. Location: Redlands, CA Benefits:
RN - Case Manager
Redlands, CA · On-site
Candidates should be familiar with utilizing InterQual criteria, and comply with CMS and HIPAA ... to manage needs assessments and care plans effectively. Location: Redlands, CA Benefits:
In this position the Case Manager, RN will provide utilization education, identification of ... Knowledge and experience with InterQual (CERME) or other national standard. Data Entry skills ...
In this position the Case Manager, RN will provide utilization education, identification of ... Knowledge and experience with InterQual (CERME) or other national standard. Data Entry skills ...
In this position the Case Manager, RN will provide utilization education, identification of ... Knowledge and experience with InterQual (CERME) or other national standard. Data Entry skills ...
In this position the Case Manager, RN will provide utilization education, identification of ... Knowledge and experience with InterQual (CERME) or other national standard. Data Entry skills ...
Candidates should be familiar with utilizing InterQual criteria, and comply with CMS and HIPAA ... to manage needs assessments and care plans effectively. Location: Redlands, CA Benefits:
Candidates should be familiar with utilizing InterQual criteria, and comply with CMS and HIPAA ... to manage needs assessments and care plans effectively. Location: Redlands, CA Benefits:
Director, Case Management
Santa Ana, CA · On-site
Job Duties: * Provides leadership and management of clinical carecoordination, utilization ... McKesson InterQual experience preferred.
Director, Case Management
Santa Ana, CA · On-site
Job Duties: * Provides leadership and management of clinical carecoordination, utilization ... McKesson InterQual experience preferred.
... with Interqual and/or Milliman criteria helpful but not required.. 1-year case management ... experience preferred. Requirements 1 yr experience. Strong computer skills Solid communication ...
... with Interqual and/or Milliman criteria helpful but not required.. 1-year case management ... experience preferred. Requirements 1 yr experience. Strong computer skills Solid communication ...
... with Interqual and/or Milliman criteria helpful but not required.. 1-year case management ... experience preferred. Requirements 1 yr experience. Strong computer skills Solid communication ...
... with Interqual and/or Milliman criteria helpful but not required.. 1-year case management ... experience preferred. Requirements 1 yr experience. Strong computer skills Solid communication ...
Evaluates andidentifies an individual's needs an intensity of case management services. * Assessment: Performs datacollection and analysis of the patient history to include, but not limitedto ...
Evaluates andidentifies an individual's needs an intensity of case management services. * Assessment: Performs datacollection and analysis of the patient history to include, but not limitedto ...
Travel Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR ...
Travel Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR ...
Job Summary Under the direction of the Case Manager or Discharge Planner, the Case Management ... faxing CCS referrals, faxing Interqual reviews and documenting in BAR, ordering supplies ...
Job Summary Under the direction of the Case Manager or Discharge Planner, the Case Management ... faxing CCS referrals, faxing Interqual reviews and documenting in BAR, ordering supplies ...
Travel Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR ...
Travel Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR ...
... Interqual Payor - Medicare/Medical exp, private insurance experience Discharge planning Hospital Case Manager experience knowledge of patient disease processes and usual methods for treating them ...
... Interqual Payor - Medicare/Medical exp, private insurance experience Discharge planning Hospital Case Manager experience knowledge of patient disease processes and usual methods for treating them ...
Post-Acute Case Manager
$35 - $38/hr
... InterQual, Milliman, health plan guidelines, and internal utilization management standards ... Understanding of care coordination, readmission prevention strategies, continuity of care practices ...
Post-Acute Case Manager
$35 - $38/hr
... InterQual, Milliman, health plan guidelines, and internal utilization management standards ... Understanding of care coordination, readmission prevention strategies, continuity of care practices ...
Case Manager (RN) - Utilization Management
$41.57 - $55.95/hr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual ...
Case Manager (RN) - Utilization Management
$41.57 - $55.95/hr
At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual ...
Coordinator-Clinical Appeals
$22.50 - $28/hr
... Management department. Reviews medical records for medical necessity of admission, severity of illness, and intensity of service based on InterQual and Milliman Guidelines. Documents in appropriate ...
Coordinator-Clinical Appeals
$22.50 - $28/hr
... Management department. Reviews medical records for medical necessity of admission, severity of illness, and intensity of service based on InterQual and Milliman Guidelines. Documents in appropriate ...
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 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?
| 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.
Contractor
Medical, Dental, Vision, Retirement
Posted 19 days ago
Job description
Apidel Technologies is seeking a local contract nurse RN Case Manager, Utilization Review for a local contract nursing job in Irvine, California.
Job Description & Requirements- Specialty: Utilization Review
- Discipline: RN
- Start Date: 06/16/2026
- Duration: 13 weeks
- 36 hours per week
- Shift: 12 hours, days
- Employment Type: Local Contract
Job Tittle: RN Case Manager
Duration: 3 Months ( Possibility to extend or convert)
Shift: Day 3x12-Hour (07:00am - 7:30pm)
Location: : Irvine, CA
Job Summary:
The Case Manager/Utilization Review RN is responsible for coordinating patient care, managing utilization review activities, ensuring medical necessity compliance, and facilitating discharge planning for acute and specialty hospital patients. This role works collaboratively with interdisciplinary teams to support quality outcomes, regulatory compliance, and appropriate resource utilization.
The ideal candidate will have strong experience in acute inpatient case management, utilization review, InterQual/Milliman guidelines, and complex care coordination within hospital settings.
Key Responsibilities:
• Perform inpatient case management and utilization review for complex acute care patients
• Conduct admission reviews, concurrent reviews, continued stay reviews, and retrospective reviews
• Evaluate medical necessity using InterQual and Milliman guidelines
• Coordinate patient care plans, discharge planning, and transitions of care
• Collaborate with physicians, nursing staff, social workers, and interdisciplinary teams
• Manage appeals, denials, and authorization processes
• Utilize Epic EMR for documentation and case management workflows
• Communicate patient status and recommendations using SBAR communication methodology
• Ensure compliance with CMS, HIPAA, Joint Commission, NCQA, OSHA, and Department of Health standards
• Support regulatory documentation, coding, billing, and quality initiatives
Required Qualifications
• Active RN State License
• BSN required
• BLS Certification required
• Minimum 5 years of Case Management/Utilization Review RN experience
• Acute hospital experience required
• Experience in Long-Term Acute Care (LTAC), Rehab, or Skilled Nursing preferred
• Epic EMR experience required
• Experience with InterQual and Milliman guidelines required
Apidel Technologies Job ID #API0673.
About Apidel TechnologiesAt Apidel Technologies LLC, we specialize in delivering high-impact
healthcare staffing solutions that empower organizations to maintain
operational excellence and deliver exceptional patient care. With our
headquarters in Illinois and regional offices in New Jersey, California, and
Georgia, we offer both nationwide reach and local insight to support the
dynamic workforce needs of healthcare providers across the U.S.
We deliver unmatched expertise in placing top-tier healthcare
professionals, including Registered Nurses, Licensed Practical
Nurses/Licensed Vocational Nurses, Certified Nursing
Assistant/Certified Medical Assistant, and Nurse Practitioners, Medical
Laboratory Scientist, Phlebotomist, Histologists, across a diverse
spectrum of care settings such as hospitals, clinics, rehabilitation centers,
long-term care facilities, correctional institutions, and more. Our deep
talent network and sector-specific understanding position us as a valuable
partner to client platforms, enabling a scalable and seamless workforce
experience for healthcare employers and job seekers.
Since our founding in 2012, Apidel has earned the trust of Fortune 500
healthcare organizations, mid-sized providers, and government agencies
at the county and state levels. We provide end-to-end staffing services,
contingent workforce solutions, direct hire, temp-to-hire, and executive
search, designed to align with your clinical and operational objectives.
As a certified WBENC firm, we are committed to Diversity, Equity,
Inclusion & Belonging (DEI&B) and take a client-centric approach that
combines industry insight, agile delivery models, and culturally competent
staffing to help our clients thrive in today’s fast-evolving healthcare
- 401k retirement plan
- License and certification reimbursement
- Medical benefits
- Dental benefits
- Vision benefits
- Referral bonus
- Sick pay
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