, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare... requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Pref...
, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic...
Level of Care Criteria or Milliman Care Guidelines and knowledge of local and national coverage determinations. ?Recent...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
limitations. The ability to apply Interqual/ Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines...
but not required. Experience: Five years of related experience required. Knowledge of InterQual Milliman MCG and similar guidelines...
Experience 2 years of experience in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred...
and other product lines. The role reports to the CFO and works closely with the Appointed Actuary at Milliman, outside investment...
) guidelines, Milliman Care guidelines, and other nationally recognized sources such as NCCN and ACOG. The Appeals and Grievance...
limitations. The ability to apply Interqual/ Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines...