and coordinating care for our high risk Cardiology and CHF patients Knowledge of Milliman criteria and utilizing these criteria...
case management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus...
. Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status. Collaborate with attending...
' experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation Length of stay: including review...
Utilization Management & Clinical Review Perform admission, concurrent, and post-discharge utilization reviews. Apply Milliman...
criteria or utilization review guidelines, such as InterQual or Milliman Ambulatory Care Guidelines. Working knowledge...
preferred. 3. Current BCLS certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay...
with payer criteria tools (InterQual, MCG/Milliman, Optum ClinicalAdvisor) and major EHR platforms (Epic, Cerner) in a revenue...
planning or management Current BLS (AHA) certificate Knowledge of Milliman Criteria and InterQual Criteria Full benefits...
regarding medical plan of care, documentation and Milliman Criteria and projected discharge date. Calls/ conversations...