current;5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic...
. Current BCLS (AHA) certificate upon hire and maintain current;5. Knowledge of Milliman Criteria and InterQual Criteria...
applying medical management treatment guidelines, such as InterQual / McKesson, Milliman, or other practical management...
knowledge of InterQual® and Milliman® clinical criteria. Proven ability to evaluate operational workflows, develop policies...
or management, preferred. 3. Current BCLS (AHA) certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare...
and Benefit Timeline. Enrollment Meetings – Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather...
in case management, discharge planning or management Current BLS (AHA) certificate Knowledge of Milliman Criteria Full...
. Ability to work independently, setting priorities to coordinate care plans efficiently. Working knowledge of Milliman...