adult patients. 6. Knowledge of InterQual or Milliman Care Guidelines preferred. Why Mercy? From day one, Mercy...
adult patients. 6. Knowledge of InterQual or Milliman Care Guidelines preferred. Why Mercy? From day one, Mercy...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
of recognized industry clinical standards, i.e. Interqual, Milliman Care Guidelines. Maintain the highest level of customer...
REQUIRED Experience: Related experience- 3 years Health Plan OR Utilization Management experience preferred JIVA and Milliman Care..., Utilization Review, Medical Necessity, JIVA, Milliman...
, Milliman, MCG, and similar guidelines required. Credentials: Licensed to practice medicine in the State of Florida...
Management Proficiency with Milliman Care Guidelines or Interqual Bilingual skills to communicate effectively with patients...
Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts...
;Discharge Planning;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR... Utilize Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding...
;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR Concurrent Review... Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding and billing...