strongly preferred. Hands-on experience with ZeOmega Jiva strongly preferred;experience with Milliman Care Guidelines (MCG...
Experience working with Milliman guidelines or other regulatory protocols, claims processing, medical coding and interpreting...
in Milliman Care Guidelines (MCG) or InterQual criteria for medical necessity, setting and level of care, and concurrent patient...
stay reviews for all of these. Clinicals received are reviewed using Milliman & company policies. If they do not meet...
Conduct continued stay reviews Review clinicals using Milliman guidelines If criteria not met: Prepare write-ups Submit...
Medicare 2MN rule, Milliman and Interqual guidelines, to guarantee expectations are consistently met as well as relevant...
. Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status. Collaborate with attending...
. Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status. Collaborate with attending...
. Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status. Collaborate with attending...
, MCG, or other clinical criteria Certified Case Manager (CCM) Knowledge of Milliman Criteria Pay is based...