necessity reviews, Milliman and Interqual criteria, and health care reimbursement regulation. 5-7 years of relevant experience...
against Milliman criteria to help determine patient class and level of care needed. Confers with MD to discuss clinical...
. Proficient in Allscripts EMR, Allscripts CM software program, Milliman Care Guidelines (MCG), IDX and 3M within 6 months....
against Milliman Care Guidelines (MCG) to identify admission status, working DRG and target LOS for all direct admits and incoming...
. Training Preferred/Desired Interqual, Milliman and Midas knowledge Special Skills Minimum Required Strong clinical...
(AHA) certificate, preferred Knowledge of Milliman Criteria and InterQual Criteria preferred Experience and knowledge in...
and criteria for admission, observation, and level of care to comply with federal and state mandates. Uses Milliman and Medicare...