, actuarial systems (e.g., PeopleSoft GL, Triton, Milliman ALFA) data architecture, data integrations and cloud platforms Proven...
, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic...
-Revenue Cycle Utilize Evidence -based clinical guideline tool (Milliman ® or InterQual ®)) Research and application...
planning or nursing management, preferred. 4. Current BLS certificate, preferred. 5. Knowledge of Milliman Criteria...
of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic to intermediate computer skills...
(AHA) certificate upon hire and maintain current. Knowledge of Milliman Criteria and InterQual Criteria preferred...
(s) utilizing InterQual (IQ), Milliman Care Guidelines (MCG), or in accordance with CMS rules and regulations for medical necessity... and clinical data. Responsible for yearly re-education on industry standard criteria, i.e., InterQual/Milliman Care Guidelines...
but not required. Experience: Five years of related experience required. Knowledge of InterQual, Milliman, MCG, and similar guidelines...
with InterQual or Milliman Guidelines. Essential Functions Census and rounds Reviews every patient under assigned workload...
years of experience in an acute or post-acute setting Required Experience using InterQual or Milliman Preferred Licenses...