Case Manager RN
Experience in use of Milliman/InterQual criteria Registered Nurse (RN) NYS license required PRI/Screen certification strongly...
Experience in use of Milliman/InterQual criteria Registered Nurse (RN) NYS license required PRI/Screen certification strongly...
Excellent communication and leadership skills;advanced knowledge of medical necessity reviews, Milliman and Interqual criteria...
. Proficient in Allscripts EMR, Allscripts CM software program, Milliman Care Guidelines (MCG), IDX and 3M within 6 months....
, PowerPoint) Proficient with medical necessity criteria including InterQual, Milliman guidelines. Strong managerial skills...
medical necessity and appropriateness by referencing regulatory mandates, contracts, benefit information, Milliman Care...
. Effective Jan 2025: MCG (Milliman Clinical Guideline) certification required within 1 year of hire or transfer. LICENSE...
neonatal/infant, child, adolescent, adult, and geriatric adult patients.6. Knowledge of InterQual or Milliman Care Guidelines...
preferred. Knowledge of Milliman Criteria and InterQual Criteria preferred....