and knowledge in basic to intermediate computer skills. 1. Current BCLS certificate preferred. 2. Knowledge of Milliman Criteria...
and benefit coverage. Applies UCLA Health protocols and national clinical guidelines (e.g., InterQual, Milliman) in review...
experience, preferred. 5. Experience in psychiatric emergency and triage preferred. 6. Knowledge of Milliman Criteria...
, such as InterQual or Milliman Ambulatory Care Guidelines. Must possess experience in performing prospective, concurrent...
using electronic medical records or acute hospital utilization review using InterQual or Milliman. Working knowledge...
Interqual or Milliman required High level of competency performing medical necessity reviews with accepted criteria required...
Interqual or Milliman required High level of competency performing medical necessity reviews with accepted criteria required...
preferred. Experienced researching Medicare clinical guidelines: NCD, LCD;Medicare Benefit Policy and Milliman Care Guidelines...
of Milliman Care Guidelines, preferred. Experience working with the Medicare and Medicaid population segment, preferred...
, working knowledge of Intequal and/or Milliman. 3. Ability to train and direct employees. PREFERRED: 1. Bachelor's degree...