regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
of interQual IS-SI, Milliman nd Robertson Managed Care Guidelines, Erickson Life Skills (Age Competencies}, Medicare Part...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
using electronic medical records or acute hospital utilization review using InterQual or Milliman. Working knowledge...
or management, preferred. Current BCLS (AHA) certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria...
of interQual IS-SI, Milliman nd Robertson Managed Care Guidelines, Erickson Life Skills (Age Competencies}, Medicare Part...
required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred...
setting required. Minimum of 2+ years utilization review or claims auditing experience required. Experience with Milliman...
, discharge planning or management, preferred. Current BCLS (AHA) certificate preferred. Knowledge of Milliman Criteria...