or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual...
criteria such as InterQual and Milliman Care Guidelines. Perform retrospective medical record reviews to validate... with InterQual and/or Milliman Care Guidelines, and electronic medical record systems. Experience with inpatient level‑of‑care...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
such as HCC and CDPS Familiarity with claims groupers such as Milliman's HCG Product management training or analytics product...
, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific...
criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare..., Milliman guidelines, InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses...
Description : What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging... unit within Milliman, Inc., a respected consultancy with offices around the world. Candidates who have their pick...
Description : What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging..., software-as-a-service (SaaS) products for a broad spectrum of insurance clients. We’re a business unit within Milliman, Inc...
- Clinical experience in hospital or medical office/clinic setting. Experience with Milliman criteria. Preferred...