UM Nurse
, Medicaid/Medi-cal criteria, Interqual, Milliman, or Health Plan specific guidelines Collaborate with the Medical Director...
Lugar: California | 12/06/2026 23:06:28 PM | Salario: S/. No Especificado | Empresa: Enterprise Engineering
Utilization Review Nurse
limitations. The ability to apply Interqual/ Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines...
Lugar: New York City, NY | 12/06/2026 21:06:55 PM | Salario: S/. No Especificado | Empresa: VillageCare
Case Manager - Utilization Management
preferred. CCM or obtained within 1year Current BCLS certificate preferred. Knowledge of Milliman Criteria and InterQual...
Lugar: Anaheim, CA | 12/06/2026 01:06:51 AM | Salario: S/. No Especificado | Empresa: West Anaheim Medical Center
Case Manager RN
. Additional Qualifications That Are a Plus: Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience...
Lugar: Mesquite, TX | 12/06/2026 01:06:12 AM | Salario: S/. No Especificado | Empresa: Dallas Regional Medical Center
Case Manager RN
That Are a Plus: Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic to intermediate computer...
Lugar: Mesquite, TX | 12/06/2026 00:06:15 AM | Salario: S/. No Especificado | Empresa: Prime Healthcare
Care Management Representative
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
Lugar: Saratoga Springs, NY | 11/06/2026 22:06:02 PM | Salario: S/. No Especificado | Empresa: Saratoga Hospital
RN Utilization Review Case Manager
Cross BLS) certification Preferred: Knowledge of InterQual and/or Milliman criteria Experience Qualifications: Minimum...
Lugar: Granite City, IL | 11/06/2026 17:06:09 PM | Salario: S/. $32 - 48 per hour | Empresa: Gateway Regional Medical Center
Actuarial Consultant, Life Modeling - Remote
Milliman’s MG-ALFA/Integrate and Moody’s GGY AXIS. Strong development environment with support for continued technical... experience with a strong foundation in life insurance. Proven hands-on actuarial modeling experience, ideally in Milliman’s MG...
Lugar: Columbus, OH | 11/06/2026 02:06:10 AM | Salario: S/. No Especificado | Empresa: Nationwide Mutual Insurance Company
Clinical Denials and Appeals RN
criteria such as InterQual and Milliman Care Guidelines. Perform retrospective medical record reviews to validate... To Have: Bachelor of Science in Nursing Master’s degree in Nursing Experience with InterQual and/or Milliman Care Guidelines...
Lugar: Birmingham, AL | 11/06/2026 01:06:24 AM | Salario: S/. $68000 - 113000 per year | Empresa: Guidehouse
RN Case Management Supervisor
patients Review medical records for admission and concurrent review requirements Apply MCG, Milliman, and InterQual criteria... BCLS certificate preferred Knowledge of Milliman Criteria and InterQual Criteria preferred Full benefits at Prime...
Lugar: Kansas City, KS | 11/06/2026 00:06:38 AM | Salario: S/. No Especificado | Empresa: Providence Medical Center