Showing 1-20 of 471
Showing 1-20 of 471
Milliman Care Guidelines jobs

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Landmark HealthCathedral City, CA

Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems is helpful....

Brown & Toland PhysiciansOakland, CA

Knowledge of managed care concepts, Medicare/Medi-Cal Guidelines. Responsible for focusing on coordination of care throughout the continuum while creating...

Hendrick Health SystemAbilene, TX

Proficient in Allscripts EMR, Allscripts CM software program, Milliman Care Guidelines (MCG), IDX and 3M within 6 months....

XSOLISNashville, TN

Experience in utilizing Interqual and/or Milliman guidelines no less than 2 years. O Determine if professionally recognized standards of quality care are met....

Accountable Health CareSignal Hill, CA

Knowledge of Milliman guidelines. Managed care experience. Collaborate with patient, family and health care providers to develop individualized plans of care...

Blue Cross Blue Shield of IL, MT, NM, OK & TXDallas, TX

Knowledge of Milliman Guidelines or similar clinical guidelines. 1 year of experience in care management/condition management in a health insurance/managed care...

Integrity Staffing SolutionsBaton Rouge, LA

Applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for appropriate utilization of...

River City Medical GroupSacramento, CA

Knowledgeof managed care principles. Able tofacilitate the continuum of care by on-site care coordination, Collaborationwith both River City (RCMG) and hospital...

ST CATHERINE HOSPITALColorado Springs, CO

Educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and case...

CENTURA SUPPORTColorado Springs, CO

Educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and case...

Florida HospitalOrlando, FL

Utilizes Utilization Management skills, including a thorough, working knowledge of InterQual criteria/Milliman Care Guidelines, by the following\:....

Daraja Enterprises, Inc.Eureka, CA

Strong working knowledge of Milliman Care guidelines and/or InterQual. Routinely discuss members’ care plans with medical directors to make adjustments as...

Community Health GroupChula Vista, CA

Knowledge of managed care principles, CPT, ICD-10, HCPCS coding, Medi-Cal benefits and experience with inpatient and outpatient medical review guidelines...

River City Medical GroupSacramento, CA

Performs concurrent review (possibly onsite) for inpatient and/or outpatient and case management to ensure appropriateness of admission, continued inpatient...

Innovative Care Management, Inc.Milwaukie, OR

Experience with MCG (formerly Milliman Care Guidelines). Recent acute care experience in general intensive care units or emergency rooms.:....

University HealthCare AllianceOakland, CA

Active, unrestricted California nursing license (RN or LPN) with a strong working knowledge of clinical criteria sets such as CMS local and national guidelines,...

Sharecare IncColumbia, MD

Milliman and Apollo Guidelines:. Knowledge and competency in all types of medical necessity decisions, including inpatient care, sub-acute/skilled care,...

VISITING NURSE SERVICE OF NEW YORKBrooklyn, NY

Experience applying medical management treatment guidelines, such as InterQual / McKesson, Milliman, or other practical management guidelines required....

Landmark HealthHarrisburg, PA

Awareness of UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems is helpful....


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