TennCare Program Coordinator
(Working Title: Quality Control Specialist)
Agency: Health Care Finance & Administration/TennCare, Eligibility Division
An Executive Service employee serves at the pleasure of the Appointing Authority. As such, if conditions arise such as work curtailment or unavailability, sub-standard work performance, poor attendance or conduct, termination of employment may occur. Further, individuals hired into this open position(s) will not have a right to appeal, or standards for the application of disciplinary procedures applying to regularly appointed employees that have achieved career status do not apply to executive service appointed employees.
The Division of TennCare is seeking two TennCare Program Coordinators (working title: Quality Control Specialist) for the Eligibility Quality & Analytics Department within the Compliance and Policy Group of Member Services. The Quality Control Specialists will be responsible for providing support and guidance to staff on matters relating to Medicaid policies and Member Services business processes, and to ensure accurate Medicaid eligibility determinations are made in the Tennessee Eligibility Determination System (TEDS). The Quality Control Specialists will review eligibility determinations and identify areas for improvement and provide recommendations regarding possible solutions. Finally, the Quality Control Specialists will also work collaboratively with the Eligibility Quality Control Director to monitor compliance with TennCare policy throughout Member Services.
- Bachelor’s Degree (preferred)
- 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
- Excellent writing and communication skills required
- Strong grasp of Medicaid policy
- Experience in quality control such as evaluating the quality of services, identifying problems and needs and recommending corrective action and improvements to ensure optimum service delivery will be considered a plus
Job Location: Nashville, Tennessee
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.
Location/Region: Nashville, TN