from on-going review process. 5. Knowledge of Milliman CareGuidelines and InterQual Criteria. 6. Behavioral Violence Prevention...
-Current Version (CPT) coding;and McKesson (InterQual) and/or Milliman Care Guidelines. Life Support Certifications...
from on-going review process. 5. Knowledge of Milliman CareGuidelines and InterQual Criteria. 6. Behavioral Violence Prevention...
, actuarial systems (e.g., PeopleSoft GL, Triton, Milliman ALFA) data architecture, data integrations and cloud platforms Proven...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation...
BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
, actuarial systems (e.g., PeopleSoft GL, Triton, Milliman ALFA) data architecture, data integrations and cloud platforms Proven...
(s) utilizing InterQual (IQ), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity... and clinical data. Responsible for yearly re-education on industry standard criteria, i.e., InterQual/Milliman Care Guidelines...
-Revenue Cycle Utilize Evidence -based clinical guideline tool (Milliman ® or InterQual ®)) Research and application...