Case Management Experience Familiarity with AllScripts Care Management Proficiency with Milliman Care Guidelines...
InterQual or Milliman/MCG criteria to validate patient status decisions and payer medical necessity compliance. Reviews medical...
guidelines, InterQual, Milliman, or similar criteria Experience in hospital or payer-facing environments Bachelor of Science...
is responsible for managing appeal processes, reviewing and understanding clinical guidelines (like Milliman/InterQual... of care (inpatient, observation, outpatient). Applies clinical guidelines (InterQual/Milliman) to validate medical necessity...
Interqual or Milliman required High level of competency performing medical necessity reviews with accepted criteria required...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
(LCSW), or Licensed Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman Criteria...