of treatments (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria). Examine and evaluate...
. Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency: St. Mary's General Hospital...
Assignment of appropriate levels of care Completion of all required documentation in Milliman and EPIC Collaborates.... Completes utilization management and quality screening for assigned patients. Applies Milliman Criteria to monitor...
of terminology CPT codes and ICD 10 Bilingual preferred Knowledge of InterQual or Milliman Care Guidelines preferred Minimum...
in any of the following is a strong preference: Milliman HCG data, Power BI, claims-based experience analysis, trend analysis...
requiredKnowledge of Medicaid and/or Medicare regulations requiredKnowledge of Milliman criteria (MCG) preferredFor UM Only: Experience...
nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual Criteria...
as necessary. Develop stewardship report based on workflows in Benefit Point. Capable of Gathering and Analyzing ICAF, Milliman...
requiredKnowledge of Medicaid and/or Medicare regulations requiredKnowledge of Milliman criteria (MCG) preferredFor UM Only: Experience...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...