Plan's provider contracts, member contracts, authorization requirements and clinical criteria including Milliman care...
of Milliman Criteria and InterQual Criteria preferred. Current BCLS certificate, preferred Pay Transparency: Chino Valley...
or nursing management, preferred. Current BCLS (AHA) certificate upon hire and maintain current;. Knowledge of Milliman...
Applies Interqual (McKesson)/Milliman or other facility endorsed in- and out-patient evidence-based programs to monitor Length... to apply Interqual/Milliman as well as other evidence based guidelines addressing entitlements and LOD. Must have knowledge of relevant...
;. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic to intermediate computer...
/Management required Experience with CCM, ACM, or Milliman preferred BLS required upon submission...
/Management required Experience with CCM, ACM, or Milliman preferred BLS required upon submission...
;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR Concurrent Review;UR Continued Stay Reviews...;UR Medical Necessity;UR Retrospective Review;UR Utilize InterQual Criteria;UR Utilize Milliman Guidelines;CMS...
QUALIFICATIONS: Experience in a pediatric acute hospital Familiarity with Interqual or Milliman Care Guidelines Experience...
and LTAC facilities and continued stay reviews for all of these. Clinicals received are reviewed using Milliman & company...