proactively to inform and alert upper management of anticipated delays. Reviews clinical against Milliman criteria to help...
Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman Criteria and InterQual Criteria...
standards of care Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare...
by capitated patients. · Assures Medicare Milliman Clinical Guideline (MCG) are used to document and communicate Intensity...
or management, preferred. Current BCLS certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred...
by capitated patients. · Assures Medicare Milliman Clinical Guideline (MCG) are used to document and communicate Intensity...
based on evidence-based clinical guidelines, i.e. Milliman Clinical Guidelines (MCG) and InterQual Criteria. Ensures... to this role: Knowledge of medical terminology. Working knowledge of InterQual, Milliman Care Guidelines, and Coding Rules...
of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Sherman Oaks Hospital offers competitive compensation...