Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts...
-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring...
or similar setting Proven awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid...
or similar setting Proven awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid...
and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer Competence, High Degree of Oral...
or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
Management in a managed care environment required and 1-3 years experience working with Milliman Care Guidelines (MCG...
: Certification in Case or Care Management;experience using InterQual or Milliman;Master?s degree preferred. Business Unit : Name...
to Third party Payers utilizing Milliman guidelines and Interqual criteria. Coordinates the discharge appeal process... review, discharge planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria...