Management experience Case Management experience Knowledge of Milliman Criteria Certified Case Manager (CCM...
Management Proficiency with Milliman Care Guidelines or Interqual Bilingual skills to communicate effectively with patients...
claims. Utilize clinical criteria such as MCG (Milliman Care Guidelines) and InterQual to support decisions related...
review;InterQual and Milliman experience required. Must have at least 2 years of Med/Surg experience. Technical Skills...
. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
. 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...
or Milliman criteria Travel Requirement:No regular travel is expected. Occasional onsite presence for audits or key meetings...
setting. Experience with Milliman criteria. Preferred Qualifications: Bachelor's Degree - Nursing or related field...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
for paramedical exams, MIB for risk assessment and fraud prevention, Milliman for actuarial analysis, and MVR for motor vehicle...