Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman Criteria and InterQual Criteria...
behavioral health admissions, concurrent stays, and discharge planning. · Apply clinical criteria (e.g., InterQual, Milliman... review tools (InterQual, Milliman). · Strong understanding of behavioral health diagnoses, treatment modalities...
: Clinical screening criteria, such as InterQual and Milliman Care Guidelines (MCG) Medicare’s Prospective Payment System...: Clinical screening criteria, such as InterQual and Milliman Care Guidelines (MCG) Medicare’s Prospective Payment System...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
with Life team at IHL, Milliman, and IRIX. Medical investigation and follow up for policies pending for further medical review...
with Life team at IHL, Milliman, and IRIX. Medical investigation and follow up for policies pending for further medical review...
in a health plan setting. (Preferred) Prior use of clinical criteria sets and clinical pathways, such as MCG ( Milliman Care...
, discharge planning or management, preferred. 3. Current BCLS (AHA) certificate preferred. 4. Knowledge of Milliman Criteria...
Social Worker (LCSW), or Licensed Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...