Managed Care Specialist

Job: Managed Care Specialist
Location : 310 Great Circle Rd. Nashville Tennessee
Duration : Long Term
Client : State of TN(TN TennCare)

TennCare will recruit a new classification for MANAGED CARE PROGRAM MGR.

This Contractor position is critical to accomplishing LTSS ID Services Team outcomes related to ensuring that the 1915(c) and Select Community programs are operating at maximum performance and ensuring that upcoming federal reporting and waiver renewal/amendment deadlines are met. The Contractor is needed to assist the ID Services Team in conducting continuous analysis and evaluation of frequent and recurring reports/deliverables/related contract amendments in efforts to enhance program improvement complete 1915(c) postpayment Utilization Reviews update/analyze/validate federally mandated 1915(c) quality data on a monthly basis and perform careful review and contribution to the upcoming(c) waiver renewals.

MINIMUM QUALIFICATIONS

Graduation from an accredited college or university with a bachelors degree and experience equivalent to 3 years of professional level experience.

Excellent Excel skills and experience with all other Microsoft Office Programs.

Experience interpreting policy or procedural provisions for a TennCare Medicaid or other related health insurance organization is preferred.

Excellent written and oral communication skills

DESIRABLE QUALIFICATIONS

Passion and commitment to supporting people with I/DD personcentered practices and integrated employment and community living

Experience with program management and/or grant management

Experience in contract management

Experience working in or with Medicaid or disability related programs

Strong work ethic and selfmotived with ability to work well on a team

Organizational skills including the ability to prioritize multitask and manage workload to meet specific timeframes and deadlines

Ability to adapt to changing priorities and deadlines

Thanks

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