, Milliman, MCG, and similar guidelines required. Credentials: Licensed to practice medicine in the State of Florida...
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
will have some travel opportunities, potentially 2-5 days per year. At Milliman we strive to deliver the best products and services... with us in that mission. Who We Are Independent for over 75 years, Milliman delivers market-leading services and solutions to clients...
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...
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...
with Interqual or Milliman guidelines and use. Proficient in process improvement, and performance monitoring. Required Work...
standards (InterQual and Milliman). Conduct admission, concurrent, and length-of-stay reviews and communicate with payors...
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...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...