or related field preferred. Current BCLS (AHA) certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria...
coverage and benefits Utilization Management experience, including experience working with InterQual Criteria and/or Milliman...
Preferred: 1. Knowledge of milliman and/or interqual criteria, utilization review, discharge planning and case management...
and best practices. Maintains computer skills. Education, Knowledge, Skills and Abilities Preferred: 1. Knowledge of milliman...
: Knowledge, skills and ability to interpret and apply medical care criteria or guidelines, such as McKesson InterQual, Milliman...
, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems The salary range for this role...
, Urgent Care, or similar setting Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines...
and/or Milliman Care guidelines Experience working with Community Care, Facets, and ICUE programs *All employees working remotely...
setting Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts...
, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems Bilingual in English/Spanish...