State of Tennessee

Nashville, TN

Government , Health Care , HR, Office & Administrative Support

Position Description / Responsibilities

The Division of TennCare is seeking a Waiver Programs Eligibility 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 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

Position Requirements

Minimum Qualifications:

Education equivalent to graduation from an accredited college, university, or professional school with one of the following:

Bachelor's Degree or 4 years relevant experience or a combination of the two

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

Preferred qualifications

Bachelor's Degree (preferred) or professional level experience interpreting policy or procedural provisions for a TennCare, Medicaid, Managed Care, or other related health insurance organization, or supervising professional staff who deal with health insurance

Application Instructions

For more information and to apply go to: tn.gov/careers
(search 20803)

Connect With the Chamber