and knowledge in basic to intermediate computer skills. 1. Current BCLS certificate preferred. 2. Knowledge of Milliman Criteria...
within established protocols Completes Utilization Management for assigned patients. Applies Milliman Care Guidelines (Indicia...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
for medical necessity across inpatient and outpatient services, applying CMS guidelines and Milliman Care Guidelines (MCG... (LCD, NCD) to assist in determinations of referrals and utilize Milliman Care Guidelines (MCG) to assist in determinations...
: Experience: Required: Minimum 3 years of general case management skills. Minimum of two years of experience utilizing Milliman...
InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL...
requirements Understanding of CPT and HCPCS coding guidelines Expertise with InterQual and Milliman disease management ideologies...
or current multi state license required. Effective Jan 2026: Current MCG (Milliman Clinical Guideline) certification...
of Interqual, Milliman or other Healthcare acute criteria preferred. Why You’ll Love Us: Health, dental, prescription...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Begins discharge planning and care...