and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG...
required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred...
. Familiarity with URAC/NCQA standards, Milliman Care Guidelines (MCG) experience preferred. Bonus: Additional certifications...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
-making criteria sets (i.e., Milliman, InterQual) Minimum of one year of experience with medical management activities...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
of experience in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses...
for improvement referring outliers to peer review. ·Reviews medical records for ongoing InterQual/Milliman compliance, quality...
Committee for improvement referring outliers to peer review. · Reviews medical records for ongoing InterQual/Milliman...
management, preferred. 4. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria...