It takes great medical minds to create powerful solutions that solve some of
healthcare’s most complex challenges. Join us and put your expertise to work in
ways you never imagined possible. We know you’ve honed your career in a
fast-moving medical environment. While Gainwell operates with a sense of
urgency, you’ll have the opportunity to work more flexible hours. And working at
Gainwell carries its rewards. You’ll have an incredible opportunity to grow your
career in a company that values work-life balance, continuous learning, and
career development.
SUMMARY
The Chiropractic Consultant will review Medicaid Prior Authorizations based on
medical necessity in accordance with State policy guidelines, provide guidance
and support for Medicaid Providers when appropriate, and act as a clinical SME
(or liaison) for internal Gainwell entities.
Note: This is not a patient facing position.
YOUR ROLE IN OUR MISSION
Adjudicating Chiropractic and prior authorizations based on medical necessity
and eligibility, in accordance with State policy guidelines and accepted
dental practices.
Reviewing and evaluating prior authorization submissions utilizing multiple
computer systems, and when appropriate seeking additional information or
clarification from requesting Provider
Entering prior authorization outcome into the Medicaid Management Information
System (MMIS) for processing.
Participation in monthly meetings which include Gainwell leadership,
operational staff support, clinical peers and State stakeholders.
Providing assistance and education to the provider community related to
specific prior authorization submissions, when applicable.
Offering analysis and recommendations to Gainwell and State leadership on
methods and potential process improvements related to the administration and
application of the dental program.
Review communications to providers and members on new/revised policies.
WHAT WE'RE LOOKING FOR
Minimally qualified candidates will have:
Current Chiropractic Degree (DC) or equivalent Certication license in the
state of WI (or license from another state and ability to obtain WI license
prior to position start date).
Extensive experience in the Chiropractic field, including both the provision,
delivery and appropriate pricing and coding requested services.
Knowledge of and/or experience working with the Wisconsin Medicaid program
(or other state’s 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.
WHAT YOU SHOULD EXPECT IN THIS ROLE
Fully remote work environment.
Part-time position, 20 hours per week.
This is a non-patient-facing position.
Fast-paced environment requiring strong critical thinking, organization, and
attention to detail.
Weekend hours may be flexible; however, candidates must be available to work
weekends as needed to support operational requirements.
Applications will be accepted through October 9, 2026.
The pay range for this position is $40,000.00 - $50,000.00 per year, however,
the base pay offered may vary depending on geographic region, internal equity,
job-related knowledge, skills, and experience among other factors. Put your
passion to work at Gainwell. You’ll have the opportunity to grow your career in
a company that values work flexibility, learning, and career development. All
salaried, full-time candidates are eligible for our generous, flexible vacation
policy, a 401(k) employer match, comprehensive health benefits
[https://jobs.gainwelltechnologies.com/content/benefits/?locale=en_US], and
educational assistance. We also have a variety of leadership and technical
development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply
about making healthcare work better for everyone. Build your career with
Gainwell, an industry leader. You’ll be joining a company where collaboration,
innovation, and inclusion fuel our growth. Learn more about Gainwell at our
company website [https://www.gainwelltechnologies.com/] and visit our Careers
site [https://jobs.gainwelltechnologies.com/] for all available job role
openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified
applicants will receive consideration for employment without regard to race,
religion, color, national origin, gender (including pregnancy, childbirth, or
related medical condition), age, sexual orientation, status as a protected
veteran, status as an individual with a disability, or other applicable legally
protected characteristics. Gainwell Technologies defines “wages” and “wage
rates” to include “all forms of pay, including, but not limited to, salary,
overtime pay, bonuses, stock, stock options, profit sharing and bonus plans,
life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel
accommodations, reimbursement for travel expenses, and benefits.