44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines Ability to work independently...
effectively with patients and families Familiarity with AllScripts Care Management Proficiency with Milliman Care Guidelines...
effectively with patients and families Familiarity with AllScripts Care Management Proficiency with Milliman Care Guidelines...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
resolution skills and assertive communication skills required. Knowledge of InterQual ISD-A and Milliman Guidelines and third...
, and continued stays, based on the clinical documentation in the Electronic Health Record (EHR) in accordance with Milliman Care... hours of admission Knowledge of Milliman Care Guidelines Knowledge of CMS guidelines for post-acute placements...
. Additional Qualifications That Are a Plus: Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience...
of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills. Pay...
, continued-stay, and retrospective reviews. Manage appeals and denials. Apply InterQual criteria and Milliman Guidelines.... InterQual and Milliman Guidelines experience. Active Pennsylvania RN license required at submission. BLS certification and BSN...
for complex cases. Assists departmental staff with issues related to Milliman (or similar) guidelines, status determination...