, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
At least one-year experience in case management, discharge planning or management Current BLS (AHA) certificate Knowledge of Milliman...
experience, preferred. 5. Experience in psychiatric emergency and triage preferred. 6. Knowledge of Milliman Criteria...
information Apply MCG formerly known as Milliman Care Guidelines, Medicare, Health plan and other approved criteria... criteria such as MCG formerly known as Milliman Care Guidelines and its applications required. Knowledge nd work experience...
, Milliman, MCG, and similar guidelines required. Credentials: Licensed to practice medicine in the State of Florida...
Management Proficiency with Milliman Care Guidelines or Interqual Bilingual skills to communicate effectively with patients...
Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts...
;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR Concurrent Review... Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding and billing...
;Discharge Planning;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR... Utilize Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding...
Utilization Management for assigned patients. a) Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness...