BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
such as CMS-HCC, HHS-HCC, 3M, Milliman, etc. Deep understanding of CMS guidelines, compliance requirements, and audit processes...
. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience...
reviews using Milliman/InterQual criteria Advocate for patient needs while ensuring appropriate care levels and resource use... in Milliman/InterQual criteria Strong computer and documentation skills Why Work in White Plains, NY? Vibrant, growing city...
with Interqual or Milliman guidelines and use. Proficient in process improvement, and performance monitoring. Required Work...
, appropriateness of care and level of care. Use Milliman and Interqual guidelines as necessary. Collaborates with clinical teams...
and maintain current;Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic...
compliance with applicable criteria, medical policy, member eligibility, benefits and vendor contracts. Apply Milliman Care... in Case Management a plus Proficient in application and use of industry standard Utilization Management criteria (Milliman...
upon hire and maintain current;Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge...
standards (InterQual and Milliman). Conduct admission, concurrent, and length-of-stay reviews and communicate with payors...