in a managed care outpatient or community environment, preferred. Recent working knowledge of Milliman Care Guidelines, preferred...
-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring...
to Third party Payers utilizing Milliman guidelines and Interqual criteria. Coordinates the discharge appeal process... review, discharge planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria...
in a managed care outpatient or community environment, preferred. Recent working knowledge of Milliman Care Guidelines, preferred...
of Milliman Care Guidelines (MCG) or InterQual criteria. Familiarity with Medicare, Medicaid, and private insurance regulations...
of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
Work Experience 2 years of experience in an acute or post-acute setting Required Experience using InterQual or Milliman...
, Milliman) to assess medical necessity and level of care. · Collaborate with physicians, nurses, and treatment teams to ensure... review tools (InterQual, Milliman). · Strong understanding of behavioral health diagnoses, treatment modalities...