Executive Service
Background Check:
This position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.
Who we are and what we do:
TennCare is Tennessee's Medicaid managed care program, serving over 1.4 million Tennesseans, including children, pregnant women, older adults, and individuals with disabilities. With an annual budget exceeding $19.2 billion, TennCare operates under the oversight of the Centers for Medicare and Medicaid Services (CMS)..
TennCare's mission is to improve the lives of Tennesseans by providing high-quality, cost-effective care. At TennCare, we are driven by purpose. Our team is committed to improving outcomes for Tennessee's most vulnerable populations through innovation, integrity, and collaboration. Employees at TennCare report a deep sense of impact and satisfaction in their work. We prioritize people and process equally to create a workplace that values meaningful service, professional development, and shared success.
Job Overview:
TennCare compensation is equitable and will be based on education and experience for a qualified candidate in accordance with Department of Human Resources (DOHR) policy
The Division of TennCare is dedicated to providing our employees with a hybrid work environment All TennCare positions have a combination of work from home and work in the office, which varies by position, department, and business need You may review the specific expectations with our hiring team
The Division of TennCare is seeking a Waiver Renewal Specialist in the Eligibility Operations Group within Member Services. This position will report directly to an Eligibility Operations Group Manager. In general, TennCare Program Coordinators on this team will work in TEDS processing applications to determine renewal eligibility for Institutional Medicaid. The TennCare Program Coordinator will work with customers, families, facilities, and Authorized Representatives to relay clear information and expectations of the information needed for an accurate eligibility determination. Additionally, the TennCare Program Coordinator will document actions in TEDS (& other systems) when necessary.
Key Responsibilities:
Review all received documents and make an eligibility determination in accordance with all rules, regulations, polices and guidelines.
Process Medicaid applications timely according to the established policies and regulations.
Provide support and guidance to assigned staff on matters relating to Medicaid rules, regulations, policies and procedures and organizational databases.
Evaluate production to ensure accuracy and that production standards are met.
Provide and participate in training, resources, and tools to increase performance and professional development of staff
Provide excellent customer service to both internal and external stakeholders
Minimum Qualifications:
Graduation from an accredited college or university with a bachelor's degree in a related field (preferred degree in business administration, management, public health, health policy, paralegal, or legal assistant studies) and 2 years of relevant work experience. OR An equivalent combination of education and work experience may be considered.
Desirable Qualifications:
Graduation from an accredited college or university with a bachelor's degree in business administration, management, public health or health policy and one of the following:
Four (4) years of experience within TennCare
Four (4) years of experience within a Medicaid, managed care or healthcare organization. AND-Ability to foster and maintain cohesive working relationships
Ability to adapt to changing priorities and deadlines -Ability to exercise sound judgment
Strong organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlines
Advanced writing and communication skills
Pursuant to the State of Tennessee's Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State's policy to provide an environment free of discrimination and harassment of an individual because of that person's race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran's status or any other category protected by state and/or federal civil rights laws.
