, and appeals using criteria such as Milliman, InterQual, ASAM, or similar Experience in Medicare and Medicaid Expertise...
setting. · Experience in Utilization Review/Management preferred. · Knowledge of InterQual and Milliman and or InterQual...
use of clinical criteria sets and clinical pathways, such as MCG ( Milliman Care Guidelines), Interqual...
with clinical criteria sets and clinical pathways, such as MCG (Milliman Care Guidelines) or InterQual. (Preferred) Familiarity... or experience with clinical criteria sets and clinical pathways, such as MCG (Milliman Care Guidelines) or InterQual. (Preferred...
and apply medical-care criteria such as InterQual or Milliman Ambulatory Care Guidelines. Working knowledge of Microsoft Windows, Word...
. Experience in psychiatric emergency and triage preferred. 6. Knowledge of Milliman Criteria and InterQual Criteria preferred. 7...
upper management of anticipated delays. Reviews clinical against Milliman criteria to help determine patient class...
BCLS certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency...
, and Word and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman...
, InterQual, Milliman, etc. 6. Facilitates peer to peer reviews with payer/providers. 7. Actively participates in clinical case...