Chiropractic Consultant

This is a fully remote position, open to applicants in Wisconsin.

📋 Description

• Assess Medicaid chiropractic prior authorizations by evaluating medical necessity, eligibility, State policy guidelines, and accepted dental practices.

• Analyze prior authorization requests through various computer systems.

• Request additional information or clarification from providers when necessary.

• Document prior authorization results in the Medicaid Management Information System (MMIS).

• Engage in monthly meetings with Gainwell leadership, operational personnel, clinical colleagues, and State stakeholders.

• Offer support and education to providers regarding specific prior authorization requests.

• Evaluate and suggest improvements to Gainwell and State leadership concerning dental program administration and application.

• Review communications directed to providers and members about new or updated policies.

• Function as a clinical subject matter expert or liaison for internal Gainwell departments.

• Perform duties in a non-patient-facing setting within a dynamic environment.

⛳️ Requirements

• Current Chiropractic Degree (DC) or equivalent certification/license in Wisconsin, or a license from another state with the capability to obtain a Wisconsin license prior to the start date.

• Comprehensive experience in the Chiropractic sector, including the provision, delivery, pricing, and coding of requested services.

• Familiarity with and/or experience in the Wisconsin Medicaid program or other state Medicaid programs.

• Exceptional interpersonal, oral, and written communication abilities.

• Capability to meet deadlines and manage priorities with minimal supervision.

• Experience collaborating with diverse partners or team members towards common objectives.

• Proficient in effective communication and interpreting policies and procedures.

• Willingness to work weekends as required to meet operational needs.

🏝️ Benefits

• Flexible hours/work flexibility.

• Work-life balance.

• Ongoing learning and career development opportunities.

• Generous and flexible vacation policy.

• 401(k) employer match.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.

• Potential for career advancement.