Care Management Representative
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria). Examine and evaluate patient...
Utilization Management for assigned patients. Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness...
Description : Who We Are Independent for over 75 years, Milliman delivers market-leading services and solutions... transformation. Milliman invests in skills training and career development, and gives all employees access to a variety of learning...
such as CMS-HCC, HHS-HCC, 3M, Milliman, etc. Deep understanding of CMS guidelines, compliance requirements, and audit processes...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
. Demonstrates awareness of nursing skills, Milliman Clinical Review criteria, NYS LOCADTR, and CMS guidelines and regulations...
. Demonstrates awareness of nursing skills, Milliman Clinical Review criteria, NYS LOCADTR, and CMS guidelines and regulations...
reviews using Milliman/InterQual criteria Advocate for patient needs while ensuring appropriate care levels and resource use... in Milliman/InterQual criteria Strong computer and documentation skills Why Work in White Plains, NY? Vibrant, growing city...