Appeals and Grievances Clinical Specialist
. Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage...
. Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage...
44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines Ability to work independently...
44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines Ability to work independently...
. Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage...
. Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage...
levels of care, monitor length of stay, and identify barriers to discharge Experience with InterQual criteria or Milliman... Experience with InterQual criteria or Milliman guidelines Knowledge of Medicare regulations, patient choice, IMM notices...
to discharge. Perform utilization review and medical necessity reviews. Apply InterQual criteria and Milliman Guidelines...
. Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage...
44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines Ability to work independently...
Review (UR) - Admission Criteria and Medical Necessity - InterQual Criteria and Milliman Guidelines - Concurrent...