RN-Case Manager

Acute Hospital,Admission Criteria,Care coordination,Discharge Planning,Utilize InterQual Criteria,Utilize Milliman Guidelines,Admission Criteria,Appeals and Denials,Concurrent Review,Continued Stay Reviews,Medical Necessity,Retrospective Review,Utilize InterQual Criteria,Utilize Milliman Guidelines,CMS: Centers for Medicare and Medicaid Services,CPT (Current Procedural Terminology) coding and billing,Department of Health,DRG (Diagnosis Related Groups),HEDIS (The Healthcare Effectiveness Data and Information Set) Measures,HIPAA guidelines (Health Insurance Portability and Accountability Act),ICD 10 Coding,NCQA (National Committee for Quality Assurance),OSHA,The Joint Commission/ Core Measure/National Safety Goals,Workers Compensation