management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation...
-Current Version (CPT) coding;and McKesson (InterQual) and/or Milliman Care Guidelines. Life Support Certifications...
. Master’s Degree in Nursing, or MBA preferred. Interqual Certified Instructor (ICQI) or Milliman training highly desired...
Interqual or Milliman required High level of competency performing medical necessity reviews with accepted criteria...
Social Worker (LCSW), or Licensed Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman...
Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current unrestricted registered nurse (RN...
Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman Criteria and InterQual Criteria...
and drug policies, medical protocols, National Comprehensive Cancer Network, Milliman Care Guidelines, Drugdex...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare...
standards of care Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare...