Interqual Jobs in Florida (NOW HIRING)

Knowledgeable in Meditech, Midas, and Interqual Must-Have: Acute (hospital) case management experience Description: This position is for a travel RN in case management. The role requires working ...

... Interqual guidelines. - Prefer demonstrated ability to learn SMHCS related facilities/services. - Prefer interpersonal communication skills and the ability to work effectively in a team. - Prefer ...

Review medical necessity using InterQual criteria. * Facilitate utilization review and resource management. * Coordinate post-acute care services and community resources. * Document patient care ...

McKesson InterQual ® experience preferred. Five years acute hospital case management experience preferred. Required skills include demonstrated organizational skills, excellent verbal and written ...

Utilize clinical experience and knowledge in accordance with established Milliman or Interqual guidelines to substantiate medical necessity and appropriate level of care. * Collaborate with health ...

McKesson InterQual ® experience preferred. Five years acute hospital case management experience preferred. Required skills include demonstrated organizational skills, excellent verbal and written ...

McKesson InterQual ® experience preferred. Five years acute hospital case management experience preferred. Required skills include demonstrated organizational skills, excellent verbal and written ...

Applies submitted information to KFHP authorization process (utilizing Milliman, USA, Interqual medical guidelines, Process Standards, Policies and Procedures, and Standard Operating Procedures)

Clinical criteria (InterQual and MCG) * Utilization/Medical record review and chart abstraction * Current standards of medical practice * Comply with HIPAA/HITECH laws and regulations Experience in:

Clinical criteria (InterQual and MCG) * Utilization/Medical record review and chart abstraction * Current standards of medical practice * Comply with HIPAA/HITECH laws and regulations Experience in:

Clinical criteria (InterQual and MCG) * Utilization/Medical record review and chart abstraction * Current standards of medical practice * Comply with HIPAA/HITECH laws and regulations Experience in:

Reviews hospital admissions to ensure appropriate admission status in accordance with MCG/InterQual criteria and to assure that the physician admits patient under the guidelines of the Managed Care ...

Knowledge of reimbursement principles, discharge planning process, InterQual and/or Milliman criteria. * Advanced written, verbal and interpersonal skills. * Must be able to deal effectively with ...

Reviews hospital admissions to ensure appropriate admission status in accordance with MCG/InterQual criteria and to assure that the physician admits patient under the guidelines of the Managed Care ...

In depth knowledge of Interqual and other references for length of stay and medical necessity determinations. Experience with NCQA. Ability to take initiative and see tasks to completion. Computer ...

... Interqual guidelines. - Prefer demonstrated ability to learn SMHCS related facilities/services. - Prefer interpersonal communication skills and the ability to work effectively in a team. - Prefer ...

ER, ICU) Experience with Utilization Review and/or Prior Authorization Familiar with Interqual Criterion Knowledge of MS Office including Word, Excel, and Outlook Responsible for completing medical ...

Make medical necessity determinations using MCG/InterQual/CMS criteria * Conduct peer-to-peer reviews and support UM staff * Participate in committees and provider education as needed Requirements

Knowledge of reimbursement principles, discharge planning process, InterQual and/or Milliman criteria. * Advanced written, verbal and interpersonal skills. * Must be able to deal effectively with ...

Experience applying InterQual and/or MCG criteria preferred * Excellent communication, analytical, and critical thinking skills * Ability to work independently in a remote environment ...