Wisconsin Licensed Chiropractic Consultant

Job Summary

Reviewing Medicaid Prior Authorizations based on medical necessity, the fully remote Wisconsin Licensed Chiropractic Consultant will provide guidance to Medicaid Providers, act as a clinical subject matter expert, and participate in operational meetings to improve the dental program.

Key responsibilities:

• Adjudicate Chiropractic and prior authorizations in accordance with State policy guidelines
• Evaluate prior authorization submissions and seek additional information from providers as needed
• Enter prior authorization outcomes into the Medicaid Management Information System (MMIS) for processing

Required qualifications:

• Current Chiropractic Degree (DC) or equivalent certification license in Wisconsin
• Extensive experience in the Chiropractic field, including pricing and coding of services
• Knowledge of or experience with the Wisconsin Medicaid program or other state's Medicaid programs
• Ability to meet deadlines and manage priorities with minimal supervision
• Experience collaborating with various partners or team members toward shared goals