Wisconsin Licensed Chiropractic Consultant

Job Summary

To support the evaluation of Medicaid Prior Authorizations, the part-time Wisconsin Licensed Chiropractic Consultant will review submissions for medical necessity, provide guidance to Medicaid Providers, and serve as a clinical liaison in a fully remote work environment.

Key responsibilities

• Adjudicate Chiropractic and prior authorizations based on medical necessity and eligibility in accordance with State policy guidelines
• Review and evaluate prior authorization submissions, seeking additional information from Providers as necessary
• Enter prior authorization outcomes into the Medicaid Management Information System (MMIS) for processing

Required qualifications

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