Social Worker (LCSW), or Licensed Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman...
Interqual or Milliman required High level of competency performing medical necessity reviews with accepted criteria...
and drug policies, medical protocols, National Comprehensive Cancer Network, Milliman Care Guidelines, Drugdex...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current unrestricted registered nurse (RN...
Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman Criteria and InterQual Criteria...
proactively to inform and alert upper management of anticipated delays. Reviews clinical against Milliman criteria to help...
of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills...
by capitated patients. · Assures Medicare Milliman Clinical Guideline (MCG) are used to document and communicate Intensity...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare...