. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications RN...
necessity reviews by utilizing Milliman and Interqual Guidelines in conjunction with a review of the patient chart, clinical...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
Policy and Milliman Care Guidelines is preferred. Experience reviewing claims and researching CPT codes or ICD-9 codes...
Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews by utilizing Milliman...
. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
and/or Medicaid (CDPS Rx, Milliman, Mercer), Quality (HEDIS / STARS) measure performance, Population Health including population...
-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring...