with Milliman (MCG) or InterQual guidelines Experience researching and preparing clinical information for case review...
, conflict resolution skills and assertive communication skills required. Knowledge of InterQual ISD-A and Milliman Guidelines...
criteria such as InterQual and Milliman Care Guidelines. Perform retrospective medical record reviews to validate... with InterQual and/or Milliman Care Guidelines, and electronic medical record systems. Experience with inpatient level‑of‑care...
adult patients. 6. Knowledge of InterQual or Milliman Care Guidelines preferred. Why Mercy? From day one, Mercy...
biannual MCG-IRR testing (Milliman Care Guidelines-Inter Rator Reliability) that is administered to clinical and medical...
, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, Medicaid/Medicare... requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Pref...
) Working toward or completion of CCM/CCP/CDE certification or Advanced degree Knowledge of Milliman Guidelines or similar...
of medical necessity justification through but not limited to non-physician review guidelines (InterQual and Milliman), Medicare...
exam. Recent documented experience with Milliman experience....
, conflict resolution skills and assertive communication skills required. Knowledge of InterQual ISD-A and Milliman Guidelines...