. Work with Milliman MedInsight data structures to support payer-provider analytics and efficiency benchmarking. Build... claims). Hands-on experience with Milliman MedInsight data models and analytics workflows. Strong SQL and data modeling...
or Milliman criteria Travel Requirement:No regular travel is expected. Occasional onsite presence for audits or key meetings...
of Milliman Care Guidelines, preferred. Experience working with the Medicare and Medicaid population segment, preferred...
of Milliman Care Guidelines, preferred. Experience working with the Medicare and Medicaid population segment, preferred...
and pharmacy claims data. Work with Milliman MedInsight data models for payer-provider analytics and benchmarking. Develop... data Payer-provider analytics Milliman MedInsight (preferred) Education & Experience Bachelor’s or Master’s degree...
in compliance with Medicare/CMS: NCD, LCD and Milliman guidelines for Inpatient, Outpatient, Skilled Facilities Level of Care... and Milliman guidelines. · Act as a liaison between the medical staff, utilization review and third-party payers to effectively...
. Working with advisory councils or governance bodies. Utilizing Milliman Care Guidelines (MCG) criteria and other state...
;Managed Care, NYSDOH and OMH guidelines;Milliman Care Guidelines and community resources. - LMSW/LCSW - MSW in Social...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...