, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Begins discharge planning and care...
of Interqual, Milliman or other Healthcare acute criteria preferred. Why You’ll Love Us: Health, dental, prescription...
by referencing regulatory mandates, contracts, benefit information, Milliman Care Guidelines, Apollo Guidelines, ASAM (American...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
applications, specifically Word, Excel, and Outlook Proficiency using Milliman Care Guidelines (MCG) and/ or InterQual criteria...
Experience working with Milliman guidelines or other regulatory protocols, claims processing, medical coding and interpreting...
. 3. Knowledge of Milliman Criteria and InterQual Criteria preferred. Employment Status: Full Time Shift: Days Equal...
Required Required Experience using InterQual or Milliman Required Licenses and Certifications Licensure or eligible for licensure, in the state...
. Work with Milliman MedInsight data structures to support payer-provider analytics and efficiency benchmarking. Build... (medical and pharmacy claims). Hands-on experience with Milliman MedInsight data models and analytics workflows. Strong SQL...
and pharmacy claims data. Work with Milliman MedInsight data models for payer-provider analytics and benchmarking. Develop... data Payer-provider analytics Milliman MedInsight (preferred) Education & Experience Bachelor’s or Master’s degree...