QUALIFICATIONS: Certification in Case or Care Management preferred. Experience using InterQual or Milliman preferred. Master’s degree...
. Demonstrates awareness of nursing skills, Milliman Clinical Review criteria, NYS LOCADTR, and CMS guidelines and regulations...
such as CMS-HCC, HHS-HCC, 3M, Milliman, etc. Deep understanding of CMS guidelines, compliance requirements, and audit processes...
. Demonstrates awareness of nursing skills, Milliman Clinical Review criteria, NYS LOCADTR, and CMS guidelines and regulations...
BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
reviews using Milliman/InterQual criteria Advocate for patient needs while ensuring appropriate care levels and resource use... in Milliman/InterQual criteria Strong computer and documentation skills Why Work in White Plains, NY? Vibrant, growing city...
with Interqual or Milliman guidelines and use. Proficient in process improvement, and performance monitoring. Required Work...
compliance with applicable criteria, medical policy, member eligibility, benefits and vendor contracts. Apply Milliman Care... in Case Management a plus Proficient in application and use of industry standard Utilization Management criteria (Milliman...
and maintain current;Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic...