Manager or Accredited Case Manager BSN preferred. Experience with Milliman Care Guidelines (MCG) Excellent verbal... or Accredited Case Manager BSN preferred. Experience with Milliman Care Guidelines (MCG)...
will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), InterQual, and/or other relevant... and Milliman Care Guidelines (MCG) medical necessity criteria Understanding of Medicare, Medicaid and third party reimbursement...
will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), InterQual, and/or other relevant...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
, InterQual, Milliman, etc. 6. Facilitates peer to peer reviews with payer/providers. 7. Actively participates in clinical case...
/CCP/CDE certification or Advanced degree Knowledge of Milliman Guidelines or similar clinical guidelines Knowledge...
of InterQual Level of Care Criteria and/or Milliman Care Guidelines and of local/national coverage determinations Experience...
. Familiarity with AllScripts Care Management preferred. Proficiency with Milliman Care Guidelines or Interqual preferred. Bilingual...
. Familiarity with AllScripts Care Management preferred. Proficiency with Milliman Care Guidelines or Interqual preferred. Bilingual...