in compliance with Medicare/CMS: NCD, LCD and Milliman guidelines for Inpatient, Outpatient, Skilled Facilities Level of Care... and Milliman guidelines. · Act as a liaison between the medical staff, utilization review and third-party payers to effectively...
and Milliman criteria preferred. Care Management certification preferred. Please complete your application using your full legal...
on Service Excellence. Working experience with medical management criteria such as Milliman and/or Interqual. Ability...
;Managed Care, NYSDOH and OMH guidelines;Milliman Care Guidelines and community resources. - LMSW/LCSW - MSW in Social...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
. Working with advisory councils or governance bodies. Utilizing Milliman Care Guidelines (MCG) criteria and other state...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
Coverage Determination (NCD) guidelines, Local Coverage Determination (LCD) Guidelines, DHCS Medi-Cal Guidelines, Milliman Care...
Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews by utilizing Milliman...
necessity reviews by utilizing Milliman and Interqual Guidelines in conjunction with a review of the patient chart, clinical...