Chiropractic Consultant – Part-time
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Job Description
Chiropractic Consultant reviewing Wisconsin Medicaid prior authorizations for medical necessity. Advising providers and improving dental program administration remotely for Gainwell Technologies.
Responsibilities:
- Review Medicaid chiropractic prior authorizations for medical necessity and eligibility in accordance with State policy guidelines and accepted dental practices
- Provide guidance and support to Medicaid providers when appropriate
- Serve as a clinical subject-matter expert or liaison for internal Gainwell entities
- Review and evaluate prior authorization submissions using multiple computer systems
- Seek additional information or clarification from requesting providers when appropriate
- Enter prior authorization outcomes into the Medicaid Management Information System (MMIS)
- Participate in monthly meetings with Gainwell leadership, operational staff, clinical peers, and State stakeholders
- Provide assistance and education to providers regarding specific prior authorization submissions
- Analyze and recommend process improvements to Gainwell and State leadership regarding administration and application of the dental program
- Review communications to providers and members concerning new or revised policies
- Work in a non-patient-facing capacity
Requirements:
- Current Chiropractic Degree (DC) or equivalent certification/license in the state of Wisconsin, or a license from another state and ability to obtain a Wisconsin license before the position start date
- Extensive experience in the Chiropractic field, including provision, delivery, appropriate pricing, and coding of requested services
- Knowledge of and/or experience working with the Wisconsin Medicaid program or other state Medicaid programs
- Excellent interpersonal, oral, and written communication skills
- Ability to meet deadlines and manage priorities with minimal direct supervision
- Experience working with various partners or team members toward shared goals
- Ability to communicate effectively and interpret policies and procedures
- Availability to work weekends as needed to support operational requirements
Benefits:
- Flexible work flexibility
- Work-life balance
- Continuous learning and career development
- Flexible vacation policy (for salaried, full-time candidates)
- 401(k) employer match (for salaried, full-time candidates)
- Comprehensive health benefits (for salaried, full-time candidates)
- Educational assistance (for salaried, full-time candidates)
- Leadership and technical development academies
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