-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications RN - Registered...
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...
as needed. Utilize InterQual and Milliman guidelines for utilization review. Maintain accurate documentation in Epic. Ensure compliance...
abilities. Ability to work collaboratively across all levels of the organization. Knowledge of InterQual or Milliman Care...
/ Order DME Plan of Care Pre-Cert Review* Prior Authorizations* Utilize InterQual Criteria* Utilize Milliman Guidelines...
abilities. Ability to work collaboratively across all levels of the organization. Knowledge of InterQual or Milliman Care...
) · Milliman experience (preferred) · Knowledge of NCQA (preferred) · Microsoft suite (Word, Excel, Outlook) (preferred... Management, Milliman, NCQA We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits...
management activities. Familiarity with established clinical decision-support criteria, such as InterQual and Milliman...
: Talroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQA The...
management activities. Familiarity with established clinical decision-support criteria, such as InterQual and Milliman...