Chiropractic Consultant – Part-time

🔥 0 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $90.9k - $129.9k / year

⏱ Part Time

🟡 Mid-level

🟠 Senior

💼 Consultant

🦅 H1B Visa Sponsor

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• 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