, Milliman, or Health Plan specific guidelines Collaborate with the Medical Director to ensure the integrity of adverse...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
of experience in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses...
-making criteria sets (i.e., Milliman, InterQual) Minimum of one year of experience with medical management activities...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
for improvement referring outliers to peer review. ·Reviews medical records for ongoing InterQual/Milliman compliance, quality...
, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems Pay is based on several factors including...
criteria, such as, but not limited to, InterQual or Milliman Ambulatory Care Guidelines. Shall have a minimum of two (2...
criteria, such as, but not limited to, InterQual or Milliman Ambulatory Care Guidelines. Shall have a minimum of two (2...
criteria, such as, but not limited to, InterQual or Milliman Ambulatory Care Guidelines. Shall have a minimum of two (2...