or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current...
and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer Competence, High Degree of Oral...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
Management in a managed care environment required and 1-3 years experience working with Milliman Care Guidelines (MCG...
: Certification in Case or Care Management;experience using InterQual or Milliman;Master?s degree preferred. Business Unit : Name...
LOS to other disciplines for timely discharge planning. Provides timely clinical reviews to Third party Payers utilizing Milliman guidelines... planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria. Understanding EPIC...
necessity criteria such as InterQual and/or Milliman Care Guidelines. Key Accountabilities: Provides annual performance...
to Third party Payers utilizing Milliman guidelines and Interqual criteria. Coordinates the discharge appeal process... review, discharge planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria...
with at least one prominent actuarial modeling software platforms, including but not limited to: Moodys GGY AXIS, FIS Prophet, Milliman ALFA...
applying Milliman and/or Interqual guidelines required. Familiarity with medical coding, reimbursement, and insurance practices...