, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
by capitated patients. · Assures Medicare Milliman Clinical Guideline (MCG) are used to document and communicate Intensity...
standards of care Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare...
Knowledge of terminology CPT codes and ICD 10 Bilingual preferred Knowledge of InterQual or Milliman Care Guidelines preferred...
in an acute care setting preferred. Working knowledge of InterQual IS-SI Milliman and Robertson Managed Care guidelines, Erickson...
in an acute care setting preferred. Working knowledge of InterQual IS-SI Milliman and Robertson Managed Care guidelines, Erickson...
by capitated patients. · Assures Medicare Milliman Clinical Guideline (MCG) are used to document and communicate Intensity...
or management, preferred. Current BCLS certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred...
based on evidence-based clinical guidelines, i.e. Milliman Clinical Guidelines (MCG) and InterQual Criteria. Ensures... to this role: Knowledge of medical terminology. Working knowledge of InterQual, Milliman Care Guidelines, and Coding Rules...