and/or Medicaid guidelines Experience with Milliman (MCG) or InterQual guidelines Experience researching and preparing clinical...
-authorization experience Utilization Management experience Case Management experience Knowledge of Milliman Criteria Certified...
of clinical experience as a NP or PA Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines...
organization Experience in a telephonic role Knowledge of Interqual or Milliman guidelines (MCG) *All employees working...
, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems Pay is based on several factors including...
Advantage and/or Medicaid (CDPS Rx, Milliman, Mercer), Quality (HEDIS / STARS) measure performance, Population Health including...
Required Experience using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
Health, or Business from an accredited college or university is preferred. Prior experience using Milliman or InterQual...
(within past 3 years) working knowledge of Milliman Care Guidelines, preferred. Minimum of three years (3) in clinical medical...
(within past 3 years) working knowledge of Milliman Care Guidelines, preferred. Minimum of three years (3) in clinical medical...