or similar setting Proven awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid...
or similar setting Proven awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid...
and Milliman Care Guidelines Experience, Leadership and Management Skills, Excellent Computer Competence, High Degree of Oral...
or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
Management in a managed care environment required and 1-3 years experience working with Milliman Care Guidelines (MCG...
or Accredited Case Manager BSN preferred. Experience with Milliman Care Guidelines (MCG) Excellent verbal and written... preferred. Experience with Milliman Care Guidelines (MCG)...
: Certification in Case or Care Management;experience using InterQual or Milliman;Master?s degree preferred. Business Unit : Name...
LOS to other disciplines for timely discharge planning. Provides timely clinical reviews to Third party Payers utilizing Milliman guidelines... planning/quality assurance/infection control. Knowledge of Milliman guidelines and Interqual criteria. Understanding EPIC...
necessity criteria such as InterQual and/or Milliman Care Guidelines. Key Accountabilities: Provides annual performance...