: Experience: Required: Minimum 3 years of general case management skills. Minimum of two years of experience utilizing Milliman...
no call or floating required MUST HAVE experience with Milliman Care Guidelines and Acute Hospital Experience! The... Authorizations Utilize Milliman Guidelines CMS: Centers for Medicare and Medicaid Services CPT (Current Procedural Terminology...
by referencing regulatory mandates, contracts, benefit information, Milliman Care Guidelines, Apollo Guidelines, ASAM (American...
or current multi state license required. Effective Jan 2026: Current MCG (Milliman Clinical Guideline) certification...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Begins discharge planning and care...
of Interqual, Milliman or other Healthcare acute criteria preferred. Why You’ll Love Us: Health, dental, prescription...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
requirements Understanding of CPT and HCPCS coding guidelines Expertise with InterQual and Milliman disease management ideologies...
or current multi state license required. Effective Jan 2026: Current MCG (Milliman Clinical Guideline) certification...
certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Employment Status Full Time Shift...