. Current BCLS (AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience...
. Work with Milliman MedInsight data structures to support payer-provider analytics and efficiency benchmarking. Build... claims). Hands-on experience with Milliman MedInsight data models and analytics workflows. Strong SQL and data modeling...
of Milliman Care Guidelines, preferred. Experience working with the Medicare and Medicaid population segment, preferred...
of Milliman Care Guidelines, preferred. Experience working with the Medicare and Medicaid population segment, preferred...
or nursing management, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Behavioral Violence...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
and pharmacy claims data. Work with Milliman MedInsight data models for payer-provider analytics and benchmarking. Develop... data Payer-provider analytics Milliman MedInsight (preferred) Education & Experience Bachelor’s or Master’s degree...
in compliance with Medicare/CMS: NCD, LCD and Milliman guidelines for Inpatient, Outpatient, Skilled Facilities Level of Care... and Milliman guidelines. · Act as a liaison between the medical staff, utilization review and third-party payers to effectively...
. Working with advisory councils or governance bodies. Utilizing Milliman Care Guidelines (MCG) criteria and other state...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...