. Current BCLS certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency...
required, but Bachelor’s degree preferred. Basic knowledge of medical necessity criteria such as Milliman Care Guidelines or Interqual...
, InterQual criteria, Milliman Care Guidelines (MCG), Perspective Payment System and medical terminology is necessary...
Previous Case Management experience preferred Preferred 1-3 years Experience in the use of Milliman/InterQual criteria...
of acute care nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual...
criteria or utilization review guidelines, such as InterQual or Milliman Ambulatory Care Guidelines. Working knowledge...
nursing experience. preferred 5. CCM or obtained within 1year 6. Knowledge of Milliman Criteria and InterQual Criteria...
– Conduct enrollment meetings as necessary Reporting ICAF/Milliman/DMW – Gather Data necessary and submit to carriers...
License certified coder Utilization Management experience Case Management experience Knowledge of Milliman Criteria...
of InterQual ISD-A and Milliman Guidelines...