and appropriateness of behavioral health services Apply clinical guidelines and tools such as InterQual, MCG, ASAM, or LOCUS Conduct... review Strong knowledge of medical necessity criteria (InterQual, MCG, ASAM, LOCUS preferred) Excellent communication...
for secondary reviews and P2Ps;maintain payer-specific medical policy expertise (CMS/MA/commercial) and InterQual/MCG criteria... documentation practices and audit readiness;coordinate with Compliance and Legal on complex cases. Talent Management (Direct...
Company Description At Mission Critical Group (MCG), we don’t just manufacture electrical systems—we deliver power..., additional projects and/or tasks may be assigned to meet operational needs. MCG retains the right to change or assign...
Company Description At Mission Critical Group (MCG), we don’t just manufacture electrical systems—we deliver power..., additional projects and/or tasks may be assigned to meet operational needs. MCG retains the right to change or assign...
, Milliman, MCG, and similar guidelines required. Credentials: Licensed to practice medicine in the State of Florida.... Visit us online at www.BrowardHealth.org or contact Talent Acquisition *Bonus Exclusions may apply in accordance...
the team member is working. Knowledge, Skills and Abilities Medical Necessity Criteria (Interqual, MCG) knowledge... Utilization Management Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the...
that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility... as per MCG guidelines. Creates, manages and maintains the 24/7 UR RN schedule and assures coverage...
. This role involves performing initial reviews of outpatient cases using criteria specific to Medicare, MediCal, and MCG... experience in utilization management. Knowledge of MCG criteria. Experience working with provider offices. Familiarity...
Company Description At Mission Critical Group (MCG), we don’t just manufacture electrical systems—we deliver power.... This role drives the deployment of The MCG Way by strengthening strategy execution, process discipline, and continuous...
Company Description At Mission Critical Group (MCG), we don’t just manufacture electrical systems—we deliver power... engineering practices across multiple locations for continuity of equipment manufacturing, Execute The MCG Way by applying...