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 managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities. TennCare provides coverage for approximately 1.7 million Tennesseans and operates with an annual budget of approximately $14 billion. It is run by the Division of TennCare with oversight and some funding from 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. To fulfill that purpose, we equip each employee for active participation and empower teams to communicate and work collaboratively to improve organizational processes in order to make a difference in the lives of our members. Because of the positive impact TennCare has on the lives of the most vulnerable Tennesseans, TennCare employees report that their work provides them with a sense of meaning, purpose, and accomplishment. TennCare leadership understands that employees are our most valuable resource and ensures professional and leadership development are a priority for the agency.
Job Overview:
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.
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 Quality Improvement Division is an integral team within the Medical Office that is responsible for monitoring, reporting, and leading innovative strategies focused on improving clinical quality and health outcomes. Operationally, the Quality Improvement Division works closely with several TennCare divisions to lead the development and execution of a comprehensive quality strategy. Additionally, the Quality Improvement team plays a strategic role in TennCare initiatives focused on improving clinical care and outcomes for TennCare members, including efforts to address social risk factors that impact health outcomes, primary care transformation and population health. Externally, the Quality Improvement Division works closely with TennCare's contracted managed care organizations (MCOs) and other state agencies to provide oversight of quality performance and data reporting for TennCare members.
The Quality Improvement Division leads TennCare's Health Starts Initiative. The Health Starts Initiative is TennCare's comprehensive effort to address health-related social needs and social risk factors that have an outsized impact in driving poor health outcomes for TennCare members. The Health Starts Initiative focuses on implementing evidence-based clinical support, resources, and technological enhancements to meet social risk needs consistently for all members. The Health Starts Program Lead will work directly with the Director of Social Determinants of Health and SDOH Program Coordinator to support implementation activities for the Health Starts Initiative and other health-related social needs efforts across the agency.
Key Responsibilities:
- Provide daily program oversight to MCOs and other external partners on Health Starts provider and community-based programs
- Serve as the primary point of contact for MCOs and Health Starts Provider Partnerships providers
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Lead and organize regular Health Starts meetings with MCOs, including agenda preparation, materials development, note-taking, and written follow-ups.
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Monitor key milestones and associated deliverables to ensure program goals are met timely.
- Support implementation and ongoing optimization of Tennessee Community Compass, TennCare's statewide closed-loop referral system, by coordinating efforts across internal teams, external providers, and the system vendor
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Support Health Starts workforce development initiatives, including strategic community health worker investments, to strengthen and inform CHW program efforts
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Contribute to long term program planning by capturing insights, best practices, and lessons learned across all Health Starts programs
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Support the development of sustainable strategies for future program design and implementation
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Help monitor program resources and identify opportunities to strengthen or expand Health Starts efforts
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Assist in developing program evaluation approaches and metrics to assess performance and stakeholder experience
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Stay informed on national standards and emerging trends to guide program alignment and measure development
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Monitor Health Starts program budget and track expenditures to ensure alignment with financial expectations and strategic priorities.
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Support financial oversight by preparing updates, summaries, and projections for QI and Chief Medical Office leadership review
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Collaborate with fiscal teams to ensure accurate processing, reporting, and reconciliation of program-related expenses
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Assist in assessing budget needs and informing resource planning for program growth and sustainability
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Conduct research, analysis, and literature reviews to identify new and emerging best practices to integrate into the Health Starts initiative and long-term health equity strategy
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Attend webinars, conferences, and workgroups as needed to advance knowledge and awareness of social determinants of health efforts
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Review new publications, innovative models, and CMS guidance to identify new avenues to drive impact for TennCare members in addressing social risk factors
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Participate in design sessions as a thought partner to support the continued evolution and growth of Health Starts strategy
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Support high priority clinical and quality improvement initiatives
- Assist in ad hoc projects, data development and strategies, and problem solve in partnership with other teams
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Collaborate with internal staff from other TennCare initiatives and programs as needed
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Handle special projects as assigned by Chief Quality Officer or SDOH Director
Minimum Qualifications:
- A bachelor's degree from an accredited college or university in public policy, health policy, public health, public administration, business administration or a related field and 3 years of experience in policy interpretation and application or similar work.
Or
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An equivalent combination of education and work experience may be considered.
Desirable Qualifications:
A master's degree in public health, healthcare administration, or related field and 2+ years full time professional experience in a healthcare setting or coordinating the implementation of health programs
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A bachelor's degree in public health, healthcare administration, or related field and 4+ years full-time professional experience in a healthcare setting or coordinating the implementation of health programs
Experience with health equity, health care delivery, health policy, or value-based payment preferred;
Ability to work independently and collaborate and communicate with important stakeholders;
Demonstrated experience managing program budgets, monitoring financial performance, analyzing expenditures, and ensuring resources are effectively allocated to meet program objectives;
Proficiency in Microsoft Office software including Word, Excel, and PowerPoint;
Demonstrated time management skills and proven ability to manage multiple tasks simultaneously while completing work within allocated time frames.
Strong organizational skills, including the ability to prioritize multiple projects
Ability to work well with multiple teams and stakeholders
Excellent communication, collaborative, and presentation skills
Ability to adapt and remain flexible in a changing, fast-paced environment
Strong skills in project and/or program management
Ability to translate qualitative and quantitative data into actionable recommendations
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.
