Digital Quality Specialist

State of Tennessee

Nashville, TN

Health Care


Position Description / Responsibilities

Statistical Research Specialist

 

TENNCARE OVERVIEW

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 1.3 million Tennesseans and operates with an annual budget of approximately $12 billion.  It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).

 

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

 

Quality Improvement:

The Quality Improvement Division is an integral team within the Chief Medical Office 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 primary care transformation and population health. Externally, the Quality Improvement Division works closely with TennCare’s contracted organizations and other state agencies to provide oversight of quality performance and data reporting for TennCare members.

 

The Quality Improvement team operates the Patient Centered Medical Home (PCMH) program and Tennessee Health Link (THL) program. The THL and PCMH programs are the leading programs in TennCare’s primary care transformation initiatives supporting comprehensive care delivery and payment model innovation to improve the quality of primary care services for TennCare members and support population health of our primary care and primary mental health providers. TennCare provides a cloud-based population health technology platform called the Care Coordination Tool (CCT) to all PCMH and THL providers. The key functions of the CCT platform include the following:


Position Requirements

QUALIFICATIONS

Minimum Qualifications:

A master’s degree and 2+ years full time professional experience in a healthcare setting or coordinating the implementation of health programs

-- OR—

A bachelor’s degree and 5+ years full time professional experience in a healthcare setting or coordinating the implementation of health programs

In depth knowledge and user experience with population health software, care coordination platforms, and/or practice management through electronic medical records systems

Expertise in Microsoft Office software including Word, Excel, Outlook and PowerPoint

Experience in fast-paced and dynamic work environment

Strong organizational skills including the ability to prioritize multiple projects

Ability to be a self-starter, work independently, and collaborate with multiple stakeholders

Excellent communication and presentation skills

 

Desired Qualifications:

Experience with health insurance, health care delivery, health policy, or value-based payment

Experience with training individuals to use health information technology

Knowledge of primary care clinic workflows

Experience with calculating HEDIS or other claims-based health care quality measurements

Knowledge of basic medical billing and coding related to HEDIS measurement

 

Job Location:  Nashville, Tennessee

 

Salary Range:  Compensation arrangements are competitive and will be commensurate with the selected candidate’s experience and responsibilities of this position.  

 

 

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.

 

 

 


Application Instructions

How to Apply: Qualified candidates should send a cover letter with salary expectations, resume, and writing sample to Rhonda.F.Fletcher@tn.gov by December 11, 2019.

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