years' professional clinical experience. Working knowledge of Milliman Care Guidelines (MCG) and/or ability to learn...
: Knowledge, skills and ability to interpret and apply medical care criteria or guidelines, such as McKesson InterQual, Milliman...
and best practices. Maintains computer skills. Education, Knowledge, Skills and Abilities Preferred: 1. Knowledge of milliman...
Preferred: 1. Knowledge of milliman and/or interqual criteria, utilization review, discharge planning and case management...
, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems Bilingual in English/Spanish...
systems Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts...
and/or Milliman Care guidelines Experience working with Community Care, Facets, and ICUE programs *All employees working remotely...
and/or Milliman Care guidelines Experience working with Community Care, Facets, and ICUE programs *All employees working remotely...
with health care payer claims analysis, payer reporting, Premier Quality Advisor, Midas Care Management, Milliman Medinsight...
. Current BCLS (AHA) certificate, preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience...