field preferred. Current BCLS certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred...
(AHA) certificate upon hire and maintain current. Knowledge of Milliman Criteria and InterQual Criteria preferred...
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria). Examine and evaluate patient...
Utilization Management for assigned patients. Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness...
such as CMS-HCC, HHS-HCC, 3M, Milliman, etc. Deep understanding of CMS guidelines, compliance requirements, and audit processes...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
. Demonstrates awareness of nursing skills, Milliman Clinical Review criteria, NYS LOCADTR, and CMS guidelines and regulations...
. Demonstrates awareness of nursing skills, Milliman Clinical Review criteria, NYS LOCADTR, and CMS guidelines and regulations...