and LTAC facilities and continued stay reviews for all of these. Clinicals received are reviewed using Milliman & company...
years of clinical experience in hospital or medical office/clinic setting. Experience with Milliman criteria. Preferred...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
of acute care nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual...
the patient's admission and continued stay for medical necessity, appropriateness of care and level of care. Use Milliman...
for ongoing InterQual/Milliman compliance, quality improvement, and utilization review per CMS guidelines and hospital policy...
nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual Criteria...
on preventing and appealing denials and educates on medical necessity criteria such as InterQual and/or Milliman Care Guidelines...
for ongoing InterQual/Milliman compliance, quality improvement, and utilization review per CMS guidelines and hospital policy...
’ clinical presentation against Milliman Care Guidelines (MCG) to identify admission status, working DRG and target...