and knowledge in basic to intermediate computer skills. 1. Current BCLS certificate preferred. 2. Knowledge of Milliman Criteria...
or insurance setting Experience applying Medicare and/or Medicaid guidelines Experience with Milliman (MCG) or InterQual...
and knowledge in basic to intermediate computer skills. 1. Current BCLS certificate preferred. 2. Knowledge of Milliman Criteria...
by capitated patients. · Assures Medicare Milliman Clinical Guideline (MCG) are used to document and communicate Intensity...
by capitated patients. · Assures Medicare Milliman Clinical Guideline (MCG) are used to document and communicate Intensity...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
and creation of new tools, and development of marketing materials. Maintain relationship with Milliman in support of claims trends... to support Self-insured reconciliations, including managing financial relationship with Milliman in support of our contract...
or insurance setting Experience applying Medicare and/or Medicaid guidelines Experience with Milliman (MCG) or InterQual...
functions. 1. Standard office environment SKILLS AND ABILITIES: 1. Working Knowledge of InterQual and/or Milliman Care...
members on concepts as needed. Provide training on DRG & Clinical Validation, Short Stay, to include Milliman, InterQual...