in Benefit Point. Capable of Gathering and Analyzing ICAF, Milliman, Aggregate and DMW reports. Initiate own correspondence...
required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred...
Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current unrestricted registered nurse (RN...
care management experience is preferred. Experience in the use of InterQual/Milliman criteria preferred. Basic computer...
. Familiarity with URAC/NCQA standards, Milliman Care Guidelines (MCG) experience preferred. Bonus: Additional certifications...
and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG...
/Milliman/DMW – Gather Data necessary and submit to carriers. Compile information for Sr. Account Consultant/Executive Team Lead...
and/or Medicare regulations requiredKnowledge of Milliman criteria (MCG) preferredFor UM Only: Experience must be with a Managed Care...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
-making criteria sets (i.e., Milliman, InterQual) Minimum of one year of experience with medical management activities...