or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current...
and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer Competence, High Degree of Oral...
Management in a managed care environment required and 1-3 years experience working with Milliman Care Guidelines (MCG...
: Certification in Case or Care Management;experience using InterQual or Milliman;Master?s degree preferred. Business Unit : Name...
necessity criteria such as InterQual and/or Milliman Care Guidelines. Key Accountabilities: Provides annual performance...
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...
to Third party Payers utilizing Milliman guidelines and Interqual criteria. Coordinates the discharge appeal process... review, discharge planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria...
with at least one prominent actuarial modeling software platforms, including but not limited to: Moodys GGY AXIS, FIS Prophet, Milliman ALFA...
applying Milliman and/or Interqual guidelines required. Familiarity with medical coding, reimbursement, and insurance practices...
but not limited to: Moodys GGY AXIS, FIS Prophet, Milliman ALFA/Integrate, Aon Benfield PathWise, Slope, PolySystems, among...