. Ability to apply Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines. Ability to understand and apply coverage...
Preferred: Bachelor's of Nursing with knowledge of InterQual Level of Care Criteria and/or Milliman Care Guidelines and of local...
, InterQual Criteria, Milliman Criteria, and Transfer DRGs. Has the maturity to work independently and remotely. EDUCATION...
degree Knowledge of Milliman Guidelines or similar clinical guidelines Knowledge of medical management policies...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
, InterQual Criteria, Milliman Criteria, and Transfer DRGs. Has the maturity to work independently and remotely. EDUCATION...
or higher (i.e. ER, ICU, etc.) Experience in a managed care organization Knowledge of Interqual or Milliman guidelines...
. Knowledge of InterQual or MCG (Milliman) criteria. Knowledge of current NCQA/URAC standards. 2+ years of relevant clinical...
Prepares utilization reviews of professionally administered medications using InterQual/Milliman and criteria and verifies...
or higher (i.e. ER, ICU, etc.) Experience in a managed care organization Knowledge of Interqual or Milliman guidelines...