-Current Version (CPT) coding;and McKesson (InterQual) and/or Milliman Care Guidelines. Life Support Certifications...
required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
. Master’s Degree in Nursing, or MBA preferred. Interqual Certified Instructor (ICQI) or Milliman training highly desired...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills...
Social Worker (LCSW), or Licensed Social Worker (LSW). 2. Current BCLS certificate preferred. 3. Knowledge of Milliman...
Interqual or Milliman required High level of competency performing medical necessity reviews with accepted criteria...
of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills...