review of selected hospital core measures or for review by external agencies such as the JCAHO, CMS and/or QIO. Collects...
), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity criteria to monitor... review or CMS rules and regulations for appropriate Level of Care and status on all patients through collaboration with Case...
), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity criteria to monitor... review or CMS rules and regulations for appropriate Level of Care and status on all patients through collaboration with Case...
), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity criteria to monitor... review or CMS rules and regulations for appropriate Level of Care and status on all patients through collaboration with Case...
), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity criteria to monitor... review or CMS rules and regulations for appropriate Level of Care and status on all patients through collaboration with Case...
review of selected hospital core measures or for review by external agencies such as the JCAHO, CMS and/or QIO. Collects...
), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity criteria to monitor... review or CMS rules and regulations for appropriate Level of Care and status on all patients through collaboration with Case...
), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity criteria to monitor... review or CMS rules and regulations for appropriate Level of Care and status on all patients through collaboration with Case...
Assurance (NCQA) Health Effectiveness Data and Information Set (HEDIS) principles, accrediting requirements, and CMS Star...
to all standards set forth by state and accrediting agencies of TJC and CMS. Knowledge of clinical operations and procedures...