using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
. Working with advisory councils or governance bodies. Utilizing Milliman Care Guidelines (MCG) criteria and other state...
;Managed Care, NYSDOH and OMH guidelines;Milliman Care Guidelines and community resources. - LMSW/LCSW - MSW in Social...
Coverage Determination (NCD) guidelines, Local Coverage Determination (LCD) Guidelines, DHCS Medi-Cal Guidelines, Milliman Care...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
within 24 hours of admission and at least every 96 hours utilizing Milliman criteria determining appropriate patient status...
criteria sets and clinical pathways, such as MCG (Milliman Care Guidelines) or InterQual. (Preferred) Familiarity...
regulations requiredKnowledge of Milliman criteria (MCG) preferredFor UM Only: Experience must be with a Managed Care Organization...
) and/or Milliman Care Guidelines. Performs prospective, concurrent, and retrospective reviews to justify medical necessity...
. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...