) Working toward or completion of CCM/CCP/CDE certification or Advanced degree Knowledge of Milliman Guidelines or similar...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
exam. Recent documented experience with Milliman experience....
, conflict resolution skills and assertive communication skills required. Knowledge of InterQual ISD-A and Milliman Guidelines...
Level of Care Criteria or Milliman Care Guidelines and knowledge of local and national coverage determinations. ?Recent...
, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
with organizational and regulatory standards. Utilize National Coverage Determination (NCD), Local Coverage Determination (LCD), Milliman...
limitations. The ability to apply Interqual/ Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines...
. Demonstrates working knowledge about different industry criteria sets like Milliman, and InterQual. 3. Demonstrates in depth... required (such as InterQual or Milliman) Knowledge, Skills and Abilities - Strong clinical assessment skills, excellent interpersonal skills...