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...
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...
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...
necessity criteria such as InterQual and/or Milliman Care Guidelines. Key Accountabilities: Provides annual performance...
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...
Prophet, Milliman ALFA/Integrate, Aon Benfield PathWise, Slope, PolySystems, among others Strong writing, presentation...
but not limited to: Moodys GGY AXIS, FIS Prophet, Milliman ALFA/Integrate, Aon Benfield PathWise, Slope, PolySystems, among...
and apply medical care criteria, such as, but not limited to, InterQual or Milliman Ambulatory Care Guidelines. Shall have a minimum...