RN Care Manager
of Milliman/InterQual criteria. General Skills: Essential computer skills....
of Milliman/InterQual criteria. General Skills: Essential computer skills....
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
is preferred. Current BLS certificate preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred. #LI-AM5...
and coordinate with vendors (e.g. Milliman) and the investment committee. Develop, maintain and update compensation structures...
. Knowledge of Milliman Criteria and InterQual Criteria preferred. #LI-AM5 Employment Status: Per Diem Shift: Variable Equal...
): Conduct thorough clinical reviews using established guidelines (such as Milliman or InterQual) to manage commercial payer... Knowledge: Hands-on experience utilizing InterQual or Milliman Criteria for utilization review. Location and Work Type Work...
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
within established protocols Completes Utilization Management for assigned patients. Applies Milliman Care Guidelines (Indicia...
from an authorized representative. The RNs perform first level appeal reviews for members utilizing Milliman Care Guidelines, Member...
and knowledge in basic to intermediate computer skills. 1. Current BCLS certificate preferred. 2. Knowledge of Milliman Criteria...