in Benefit Point. Capable of Gathering and Analyzing ICAF, Milliman, Aggregate and DMW reports. Initiate own correspondence...
required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred...
planning, current knowledge/use of evidence-based admission criteria tools like Milliman Care Guidelines, knowledge of common...
. Familiarity with URAC/NCQA standards, Milliman Care Guidelines (MCG) experience preferred. Bonus: Additional certifications...
/Milliman/DMW – Gather Data necessary and submit to carriers. Compile information for Sr. Account Consultant/Executive Team Lead...
Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current unrestricted registered nurse (RN...
care management experience is preferred. Experience in the use of InterQual/Milliman criteria preferred. Basic computer...
and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG...
criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual...
License Experience: 1-3 years of experience in Case Review, Utilization, Billing, and coding review;InterQual and Milliman...