Senior Software Engineer
covered by Milliman. Short-Term and Long-Term Disability – Fully paid by Milliman. Equal Opportunity All qualified...
covered by Milliman. Short-Term and Long-Term Disability – Fully paid by Milliman. Equal Opportunity All qualified...
Description : Milliman's Seattle Health Practice is looking for an FSA with experience in health actuarial work... in consulting skills and advanced actuarial techniques. About Our Practice Milliman’s Seattle Health Practice partners...
Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts...
REQUIRED Experience: Related experience- 3 years Health Plan OR Utilization Management experience preferred JIVA and Milliman Care..., Utilization Review, Medical Necessity, JIVA, Milliman...
Management Proficiency with Milliman Care Guidelines or Interqual Bilingual skills to communicate effectively with patients...
;Discharge Planning;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR... Utilize Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding...
;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR Concurrent Review... Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding and billing...
Utilization Management for assigned patients. a) Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness...
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
and Milliman Care Guidelines. Knowledge of DRG and GMLOS, Managed Care and Regulatory Requirements preferred. Knowledge...