. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
knowledge of InterQual or Milliman criteria. 1 year utilization review in an acute hospital or commercial/managed care payer...
of Utilization Review using Interqual and Milliman Care Guidelines, Discharge Planning and Case Management in order to facilitate: (1...
certification or Advanced degree Knowledge of Milliman Guidelines or similar clinical guidelines Knowledge of medical management...
required Knowledge of Milliman criteria (MCG) preferred For UM Only: Experience must be with a Managed Care Organization or Health Plan...
. Knowledge of Milliman Criteria and InterQual Criteria preferred....
of treatments (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria). Examine and evaluate...
relative to established admission criteria using Milliman and communicates that information to payers, physicians.../authorization numbers for patients. Run reviews through Milliman and, if criteria meets, discuss with Case Manager...
(AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
planning or nursing management, preferred. Current BCLS (AHA) certificate, preferred. Knowledge of Milliman Criteria...