Chiropractic Consultant – Part-time

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

📋 Description

• Assess Medicaid chiropractic prior authorizations to determine medical necessity and eligibility in line with State policy guidelines and established dental practices.

• Offer guidance and support to Medicaid providers as needed.

• Act as a clinical subject-matter expert or liaison for internal Gainwell entities.

• Review and analyze prior authorization requests utilizing multiple computer systems.

• Request additional information or clarification from providers when necessary.

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

• Participate in monthly meetings with Gainwell leadership, operational staff, clinical colleagues, and State stakeholders.

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

• Evaluate and suggest process enhancements to Gainwell and State leadership concerning the administration and implementation of the dental program.

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

• Operate in a non-patient-facing role.

⛳️ Requirements

• Possession of a current Chiropractic Degree (DC) or equivalent certification/license in Wisconsin, or a license from another state with the ability to obtain a Wisconsin license before starting the position.

• Significant experience in the Chiropractic field, encompassing the provision, delivery, appropriate pricing, and coding of requested services.

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

• Exceptional interpersonal, verbal, and written communication skills.

• Capability to meet deadlines and prioritize tasks with minimal direct supervision.

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

• Proficiency in effective communication and interpreting policies and procedures.

• Availability to work weekends as required to meet operational demands.

🏝️ Benefits

• Flexible work arrangements.

• Emphasis on work-life balance.

• Opportunities for continuous learning and career growth.

• Flexible vacation policy (for salaried, full-time candidates).

• 401(k) employer matching (for salaried, full-time candidates).

• Comprehensive health benefits (for salaried, full-time candidates).

• Educational assistance (for salaried, full-time candidates).

• Access to leadership and technical development academies.