;Managed Care, NYSDOH and OMH guidelines;Milliman Care Guidelines and community resources. - LMSW/LCSW - MSW in Social...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
’ experience in Healthcare setting preferred Milliman Guidelines, evidence-based clinical practice, that help determine the...
regulations requiredKnowledge of Milliman criteria (MCG) preferredFor UM Only: Experience must be with a Managed Care Organization...
) and/or Milliman Care Guidelines. Performs prospective, concurrent, and retrospective reviews to justify medical necessity...
. Ability to work independently, setting priorities to coordinate care plans efficiently. Working knowledge of Milliman...
: Clinical screening criteria, such as InterQual and Milliman Care Guidelines (MCG) Medicare’s Prospective Payment System...
, but not limited to InterQual, Milliman Care Guidelines (MCG), etc. Collaborates with the Attending of record and the Physician Advisor...