or Tableau Actuarial domain familiarity or modeling platform experience (GGY AXIS, Milliman Integrate) Why This Role Stands...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
, Utilization, Billing, and coding review;InterQual and Milliman experience required Technical Skills: Proficiency with Microsoft...
of recognized industry clinical standards, i.e. Interqual, Milliman Care Guidelines. Maintain the highest level of customer...
, Milliman, MCG, and similar guidelines required. Credentials: Licensed to practice medicine in the State of Florida...
Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts...
REQUIRED Experience: Related experience- 3 years Health Plan OR Utilization Management experience preferred JIVA and Milliman Care..., Utilization Review, Medical Necessity, JIVA, Milliman...
Management Proficiency with Milliman Care Guidelines or Interqual Bilingual skills to communicate effectively with patients...
;Discharge Planning;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR... Utilize Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding...
;Utilize InterQual Criteria;Utilize Milliman Guidelines;UR Admission Criteria;UR Appeals and Denials;UR Concurrent Review... Milliman Guidelines;CMS: Centers for Medicare and Medicaid Services;CPT (Current Procedural Terminology) coding and billing...