necessity reviews by utilizing Milliman and Interqual Guidelines in conjunction with a review of the patient chart, clinical...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews by utilizing Milliman...
in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications RN...
. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
applying Milliman and/or Interqual guidelines required. Familiarity with medical coding, reimbursement, and insurance practices...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
and/or Medicaid (CDPS Rx, Milliman, Mercer), Quality (HEDIS / STARS) measure performance, Population Health including population...
-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring...
. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...