, such as InterQual or Milliman Ambulatory Care Guidelines. Must possess experience in performing prospective, concurrent...
, Milliman, MCG, and similar guidelines required. Credentials: Licensed to practice medicine in the State of Florida...
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria). Examine and evaluate patient...
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
reviews using Milliman/InterQual criteria Advocate for patient needs while ensuring appropriate care levels and resource use... in Milliman/InterQual criteria Strong computer and documentation skills Why Work in White Plains, NY? Vibrant, growing city...
with Interqual or Milliman guidelines and use. Proficient in process improvement, and performance monitoring. Required Work...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
compliance with applicable criteria, medical policy, member eligibility, benefits and vendor contracts. Apply Milliman Care... in Case Management a plus Proficient in application and use of industry standard Utilization Management criteria (Milliman...
standards (InterQual and Milliman). Conduct admission, concurrent, and length-of-stay reviews and communicate with payors...