on preventing and appealing denials and educates on medical necessity criteria such as InterQual and/or Milliman Care Guidelines...
in Case Management, BS or BSN or related field preferred. Current BCLS certificate preferred. Knowledge of Milliman Criteria...
or nursing management, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Behavioral Violence...
on disease processes Encourage members to make healthy lifestyle changes Document and track findings Utilize Milliman criteria...
on disease processes Encourage members to make healthy lifestyle changes Document and track findings Utilize Milliman criteria...
. Knowledge of Milliman Criteria and InterQual Criteria preferred. Behavioral Violence Prevention Training within 3 months...
. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
established criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual...
in Integrate Manage and strengthen vendor relationships, including Milliman, to support effective use of ALFA/ Integrate...
criteria (InterQual and/or Milliman). 2 years Experience requirement above, to include, 2 years of demonstrated leadership...