criteria or utilization review guidelines, such as InterQual or Milliman Ambulatory Care Guidelines. Working knowledge...
nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual Criteria...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
License certified coder Utilization Management experience Case Management experience Knowledge of Milliman Criteria...
of InterQual ISD-A and Milliman Guidelines...
% Determines medical necessity and appropriateness by referencing regulatory mandates, contracts, benefit information, Milliman...
of Milliman Criteria and InterQual Criteria preferred. Current BCLS certificate, preferred Pay Transparency: Montclair...
& Sales marketing brochures, presentations, and training materials. Review and complete LIMRA, Eastbridge and Milliman...
or related field preferred. Current BCLS certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred...
. Ability to work independently, setting priorities to coordinate care plans efficiently. Working knowledge of Milliman...