case management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus...
' experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation Length of stay: including review...
with Milliman MedInsight Experience leveraging Artificial Intelligence (AI) to improve business processes What You'll Do Lead...
with all policies and standards. Must haves: Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization... plus year) Medicare NCD/LCD and InterQual/Milliman Software (1 plus year) Retrospective claims clinical reviews (1 plus year)...
computer skills. Preferred qualifications: 1. CCM or obtained within 6 months of hire 2. Knowledge of Milliman Criteria...
criteria or utilization review guidelines, such as InterQual or Milliman Ambulatory Care Guidelines. Working knowledge...
within 1year 3. Current BCLS certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria preferred...
of the medical record to assure all parameters for MCG/Milliman criteria/InterQual which includes the medical overview... of Milliman Criteria and InterQual Criteria preferred. Pay Transparency: Resurrection Medical Center offers competitive...
preferred. 3. Current BCLS certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay...
with payer criteria tools (InterQual, MCG/Milliman, Optum ClinicalAdvisor) and major EHR platforms (Epic, Cerner) in a revenue...