, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
upon hire and maintain current;Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
standards (InterQual and Milliman). Conduct admission, concurrent, and length-of-stay reviews and communicate with payors...
Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews by utilizing Milliman...
necessity reviews by utilizing Milliman and Interqual Guidelines in conjunction with a review of the patient chart, clinical...
LOS to other disciplines for timely discharge planning. Provides timely clinical reviews to Third party Payers utilizing Milliman guidelines... planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria. Understanding EPIC...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
Knowledge in areas such as InterQual Level of Care Criteria and Milliman Criteria Physical Requirements These...
in a managed care outpatient or community environment, preferred. Recent working knowledge of Milliman Care Guidelines, preferred...
in a managed care outpatient or community environment, preferred. Recent working knowledge of Milliman Care Guidelines, preferred...