-making criteria sets (i.e., Milliman, InterQual) Minimum of one year of experience with medical management activities...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
of experience in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses...
for improvement referring outliers to peer review. ·Reviews medical records for ongoing InterQual/Milliman compliance, quality...
Committee for improvement referring outliers to peer review. · Reviews medical records for ongoing InterQual/Milliman...
management, preferred. 4. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
or management, preferred. 3. Current BCLS (AHA) certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria...
about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems Pay...
) certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency St. Mary...