of Milliman Care Guidelines, preferred. Experience working with the Medicare and Medicaid population segment, preferred...
such as HCC and CDPS Familiarity with claims groupers such as Milliman's HCG Product management training or analytics product...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual...
, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare..., Milliman guidelines, InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses...
- Clinical experience in hospital or medical office/clinic setting. Experience with Milliman criteria. Preferred...
Description : What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging..., software-as-a-service (SaaS) products for a broad spectrum of insurance clients. We’re a business unit within Milliman, Inc...
Description : What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging... unit within Milliman, Inc., a respected consultancy with offices around the world. Candidates who have their pick...
and/or Milliman criteria Evaluate medical necessity, level of care, and documentation accuracy Ensure compliance with Medicare...) Experience with InterQual (must be able to pass exam) Experience with Milliman guidelines Preferred Background in Case...