within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation...
-Current Version (CPT) coding;and McKesson (InterQual) and/or Milliman Care Guidelines. Life Support Certifications...
. Master’s Degree in Nursing, or MBA preferred. Interqual Certified Instructor (ICQI) or Milliman training highly desired...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
Social Worker (LCSW), or Licensed Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman...
Interqual or Milliman required High level of competency performing medical necessity reviews with accepted criteria...
Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman Criteria and InterQual Criteria...
Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current unrestricted registered nurse (RN...
and drug policies, medical protocols, National Comprehensive Cancer Network, Milliman Care Guidelines, Drugdex...