. Knowledge of Milliman Criteria and InterQual Criteria preferred. Behavioral Violence Prevention Training within 3 months...
. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
established criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual...
in Integrate Manage and strengthen vendor relationships, including Milliman, to support effective use of ALFA/ Integrate...
criteria (InterQual and/or Milliman). 2 years Experience requirement above, to include, 2 years of demonstrated leadership...
of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills...
(Milliman, InterQual, CMS NCD / LCD) to conduct objective medical necessity reviews and make appeal determination... authorizations. Experience with the application of clinical criteria (i.e., Milliman, InterQual, Apollo, CMS National and Local...
requirements for production actuarial models in Integrate Manage and strengthen vendor relationships, including Milliman...
. Reviews clinical against Milliman criteria to help determine patient class and level of care needed. Confers with MD...
exam. Recent documented experience with Milliman experience....