. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
. preferred CCM or obtained within 1year Knowledge of Milliman Criteria and InterQual Criteria preferred. Current BCLS...
in the medical record according to policy guidelines. Utilizes MCG- Milliman criteria to identify severity of illness...
-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
and their impact on the organization (for example, HEDIS, CAHPS, and NCQA) Knowledge in criteria set, including Milliman and InterQual...
with InterQual or Milliman Care Guidelines Prior RN case management or clinical coordination experience Bilingual (Spanish...
Familiarity with CPT coding and ICD-10 terminology Knowledge of InterQual or Milliman Care Guidelines preferred Bilingual...
and/or Milliman Guidelines Care Coordination Discharge Planning Collaboration Denial Prevention and Management Regulatory...
and/or Milliman Guidelines Care Coordination Discharge Planning Collaboration Denial Prevention and Management Regulatory...