Clinical Evaluation Manager, Utilization Management (mostly remote)
required Knowledge of Milliman criteria (MCG) preferred For UM Only: Experience must be with a Managed Care Organization or Health Plan...
required Knowledge of Milliman criteria (MCG) preferred For UM Only: Experience must be with a Managed Care Organization or Health Plan...
. 2. Current BCLS (AHA) certificate preferred. 3. Knowledge of Milliman Criteria and InterQual Criteria preferred....
to established admission criteria using Milliman and communicates that information to payers, physicians, and other members of the... numbers for patients. Run reviews through Milliman and, if criteria meets, discuss with Case Manager and if applicable sends...
, discharge planning or nursing management, preferred. Current BCLS (AHA) certificate, preferred. Knowledge of Milliman Criteria...
planning or nursing management, preferred. Current BCLS (AHA) certificate, preferred. Knowledge of Milliman Criteria...
of treatments (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria). Examine and evaluate...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
planning or nursing management, preferred. Current BCLS (AHA) certificate, preferred. Knowledge of Milliman Criteria...
. Knowledge of Milliman Criteria and InterQual Criteria preferred....
relative to established admission criteria using Milliman and communicates that information to payers, physicians.../authorization numbers for patients. Run reviews through Milliman and, if criteria meets, discuss with Case Manager...