State of Tennessee
HR, Office & Administrative Support
Position Description / Responsibilities
LTSS CHOICES and Employment and Community First CHOICES Assistant Director
(Managed Care Assistant Director)
TennCare is the State Medicaid Agency in Tennessee, providing high quality, cost effective health care to 1.4 million Tennesseans, with an annual budget of approximately $11.8 billion. Long-Term Services and Supports (LTSS) is one of the largest units within TennCare with a team of 78 highly capable staff who are committed to leading the ongoing development and operation of an innovative, sustainable, person-driven long-term services and supports (LTSS) system in which older adults and people with disabilities and chronic conditions have choice, control and access to a full array of high quality services and supports that assure optimal outcomes, such as independence, health and quality of life.
WHY WORK AT TENNCARE:
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 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 AND DEPARTMENTAL OVERVIEW:
Under supervision of the Directors of CHOICES and Employment and Community First CHOICES, an employee in this position will serve as the Assistant Director of the CHOICES and Employment and Community First CHOICES programs. This position will primarily work with the similar and overlapping aspects for both the CHOICES and Employment and Community First CHOICES.
TennCare CHOICES in Long-Term Services and Supports (or CHOICES for short) is for adults (age 21 and older) with a physical disability and seniors (age 65 and older). CHOICES offers services to help a person live in their own home or in the community. These services are called Home and Community Based Services or HCBS. These services can be provided in the home, on the job, or in the community to assist with daily living activities and allow people to work and be actively involved in their local community. CHOICES also provides care in a nursing home if this is needed.
Employment and Community First CHOICES (ECF CHOICES) is an integrated Managed Long Term Services and Supports delivery model. TennCare managed care contractors are responsible for all of the covered primary, acute, behavioral, and LTSS for members with I/DD who are enrolled in the program. ECF CHOICES is the first program of its kind in the country designed to integrate physical and behavioral health services and LTSS for individuals with intellectual and developmental disabilities (I/DD) in a person-centered manner that aligns incentives around promoting and supporting employment and integrated community living as the first and preferred option for persons with I/DD. An array of services support individuals within this program to identify, develop, obtain, and maintain employment and meaningful community integration.
The successful candidate will be responsible for supporting the Directors of CHOICES and ECF CHOICES in managing and directing the programs, contracts, performance, policies, and activities of each program.
• Assist in the oversight of the State’s three contracted MCO's, by reviewing, revising, and drafting necessary protocols, guidance documents, and memos. Collaborate with internal teams and to understand how program changes impacts their work and work closely on needed revisions
• Assist in the program management of additional LTSS contracts and services such as Fiscal Employer Agency (FEA) and Community Living Support (CLS)
• Review, analyze, trend, and summarize all contractually required reports to monitor Contractor performance. Use reports to provide analysis regarding various aspects of program development and implementation including service initiation, service delivery, visit requirements, quality of services, and employment and community integration outcomes.
• Collaborate with the Audit and Reporting team to ensure audits are administered timely and review and look at the elements needed to monitor contractual compliance and quality performance. Prepare and develop dashboards and summaries that reflect Contractors performance based on audit results.
• Utilize all report and audit results to inform program improvements and overall management of contracted partners to the Directors of CHOICES and ECF CHOICES.
• Participate and lead all regular communication meetings with FEA. Review all contract deliverables, and other activities related to contract management to ensure the contractor is achieving intended outcomes and meeting program expectations. Draft contract amendments and track all system and performance changes needed to meet expectations.
• Assist with managing the day to day operations related to the Community Living Supports housing model. This will include regular contact with housing specialist at each MCO, conducting Community Living Supports workgroups and meetings, and overseeing other aspects of this program such as reporting and interfacing with the Community Living Supports Ombudsman and other advocates and stakeholders.
• Collaborate with the Directors of CHOICES and ECF CHOICES to accurately complete critical incident and reportable event management. This will include working with the MCO’s, DIDD, and the Quality Monitoring team at TennCare LTSS to ensure cases are properly reported, investigated, and that necessary resolution and follow up actions occur within specified timelines.
• Provide technical assistance to contractors about the CHOICES and ECF CHOICES programs, as necessary.
• Assist with the creation and revision of policies, procedures, and protocols related to the CHOICES and ECF CHOICES programs.
• Conduct regular reviews of program rules and regulations and make recommendations for changes/improvements, as well as research practices in other states and maintain expertise in national best practices related to MLTSS programs for individuals with I/DD.
• Assist in the creation of member education tools and materials for the CHOICES and ECF CHOICES programs.
• Assist with tracking and trending disenrollments to include participating in weekly calls with each MCO to approve or deny recommended disenrollments.
• Assist in facilitating and maintaining contact with stakeholder groups, including the facilitation of regularly scheduled meetings and participation in stakeholder advisory groups located throughout the state.
• Conduct presentations and training as assigned.
• Other special projects as assigned.
• Graduation from an accredited college or university with a Bachelor of Science degree or at least 2 years’ experience in program management, healthcare, or working with people with I/DD, older adults, or adults with physical disabilities.
• Experience interpreting policy or procedural provisions for a TennCare, Medicaid, or other related health insurance organization is preferred.
• Experience in analyzing data and using data to drive performance and expectations
• Experience with program management and/or grant management
• Strong written and oral communication skills
• Experience supporting people with I/DD, the elderly, and/or those with physical disabilities, person-centered practices, and integrated employment and community living
• Experience working in or with Medicaid or disability related programs
• Strong work ethic and self-motived with ability to work well on a team
• Organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlines
• Ability to adapt to changing priorities and deadlines
Position Status: Executive Service
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.
Job Location: Nashville, Tennessee
How to Apply: Qualified candidates should send their resumes to Melba Floyd (email@example.com) and Matthew Brown (firstname.lastname@example.org) by November 27, 2019.