, but not limited to InterQual, Milliman Care Guidelines (MCG), etc. Collaborates with the Attending of record and the Physician Advisor...
Management and/or familiarity with Milliman Care Guidelines. Required experience in acute inpatient (hospital) nursing...
for appropriateness of setting using industry standard utilization clinical criteria including, but not limited to InterQual, Milliman...
Coverage Determination (NCD) guidelines, Local Coverage Determination (LCD) Guidelines, DHCS Medi-Cal Guidelines, Milliman Care...
within established protocols Completes Utilization Management for assigned patients. a) Applies Milliman Care Guidelines (Indicia...
for admission, observation, and level of care to comply with federal and state mandates. Uses Milliman and Medicare...
of interQual IS-SI, Milliman nd Robertson Managed Care Guidelines, Erickson Life Skills (Age Competencies}, Medicare Part...
of interQual IS-SI, Milliman nd Robertson Managed Care Guidelines, Erickson Life Skills (Age Competencies}, Medicare Part...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...
regulations as well as coverage guidelines and benefit limitations. The ability to apply Interqual/ Milliman Care Guidelines...