but not required. Experience: Five years of related experience required. Knowledge of InterQual, Milliman, MCG, and similar guidelines...
with InterQual or Milliman Guidelines. Essential Functions Census and rounds Reviews every patient under assigned workload...
and/or Medicare regulations requiredKnowledge of Milliman criteria (MCG) preferredFor UM Only: Experience must be with a Managed Care...
care management experience is preferred. Experience in the use of InterQual/Milliman criteria preferred. Basic computer...
planning, current knowledge/use of evidence-based admission criteria tools like Milliman Care Guidelines, knowledge of common...
. Familiarity with URAC/NCQA standards, Milliman Care Guidelines (MCG) experience preferred. Bonus: Additional certifications...
and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG...
Required Experience using InterQual or Milliman Preferred Licenses and Certifications Current unrestricted registered nurse (RN...
required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred...
criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual...