with Interqual or Milliman guidelines and use. Proficient in process improvement, and performance monitoring. Required Work...
upon hire and maintain current;Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
and maintain current;Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic...
is a subsidiary of Milliman;a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare..., Marketing, Finance, and Milliman partners. Key Objectives of the Role Own and grow a defined book of business with clear...
standards (InterQual and Milliman). Conduct admission, concurrent, and length-of-stay reviews and communicate with payors...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
compliance with applicable criteria, medical policy, member eligibility, benefits and vendor contracts. Apply Milliman Care... in Case Management a plus Proficient in application and use of industry standard Utilization Management criteria (Milliman...
LOS to other disciplines for timely discharge planning. Provides timely clinical reviews to Third party Payers utilizing Milliman guidelines... planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria. Understanding EPIC...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
Knowledge in areas such as InterQual Level of Care Criteria and Milliman Criteria Physical Requirements These...