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WAIVER PROGRAMS NEW APPLICATION DIRECTOR - 64687

State of Tennessee
remote work
United States, Tennessee, Nashville
Jan 22, 2025

Executive Service

Waiver Programs New Application Director Division of TennCare Member Services Division Nashville, TN Salary: Minimum Monthly Salary $5,591/month TennCare compensation is equitable and will be based on education and experience for a qualified candidate in accordance with Department of Human Resources (DOHR) policy. Closing Date: 02/03/2025

The Division of TennCare is dedicated to providing our employees with a hybrid work environment. All TennCare positions have a combination of work from home and work in the office, which varies by position, department, and business need. You may review the specific expectations with our hiring team.

This position requires a background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

Who we are and what we do:

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 1.7 million Tennesseans and operates with an annual budget of approximately $14 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).

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 worked 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 Overview:

The Division of TennCare is seeking a Waiver Programs New Application Director (TennCare Eligibility Director) in the Waiver Unit in the Eligibility Operations Group within Member Services. The Waiver Programs New Application Director will provide operational oversight and leadership to the Waiver Unit. They will work under the immediate supervision of the TennCare Eligibility Administrator (Waiver). This position will be indirectly supervising up to 50 staff and directly supervising up to 4 staff. The composition of these staff may collectively include Administrative Assistants (AAs), Managed Care Specialists 3s (MCS3s), TennCare Program Coordinators (TCPCs), TennCare Program Manager 2s (PM2s) and temporary resource staff.

The Director will assist with development of unit goals, priorities, objectives and strategies. Additionally, they will ensure communication and action plans are developed and efficiently and effectively implemented within their area of responsibility. The Director will demonstrate the ability to collaborate on problem solving and decision-making processes among their peers within Member Services. This position will create ways to build team morale and develop effective relationships with all units within Member Services. Lastly, the Waiver Programs New Application Director must maintain a current knowledge base of policy and regulations surrounding Medicaid.

Key Responsibilities:

  • Directly supervise up to four staff
  • Indirectly supervise up to 50 staff including Administrative Assistants (AAs), Managed Care Specialists 3s (MCS3s), TennCare Program Coordinators (TCPCs), TennCare Program Manager 2s (PM2s) and other worker level staff
  • Advanced proficiency in navigating, processing applications and case changes, and troubleshooting within TennCare' s Tennessee Eligibility Determination System (TEDS) database
  • Advanced knowledge of TennCare' s business processes and policies that govern daily operations
  • Identify issues impacting eligibility determinations and propose remedial measures
  • Actively engage in developing team goals, priorities, objectives, and strategies for staff
  • Ensure timeliness standards are met and/or exceeded by monitoring, assessing and addressing the team's overall performance
  • Conduct regularly scheduled staff meetings to provide timely feedback, information regarding processes, initiatives, directives, and training opportunities, as well as discuss staff ideas for continuous work process improvement
  • Utilize established reports to identify trends, errors, areas requiring improvement as well as celebrate team successes
  • Oversee ongoing team specific training efforts
  • Ensure required monthly conference discussions are conducted timely and presented in the required written format
  • Manage the performance process including goal evaluation and document review for initial, interim, and annual reviews
  • Provide clear and concise verbal and written communication and guidance to staff in a positive manner
  • Effectively communicate with internal and external customers, colleagues, TennCare members and applicants
  • Conduct regular coaching and guidance to ensure staff are meeting goals set forth by the agency and in compliance with TennCare policy and following established business processes
  • Identify areas of opportunity and provide effective problem-solving techniques to ensure that the areas of opportunity are resolved in a positive manner
  • Build team morale to ensure staff have a positive and inclusive work environment, which leads to higher job satisfaction, and results in greater team efficiencies and effectiveness

Minimum Qualifications:

Education and Experience:

  • Graduation from an accredited college or university with a bachelor's degree in a related field and two (2) years of qualifying professional experience;

OR

  • Graduation from an accredited college or university with an associate degree in a related field and four (4) years of qualifying professional experience

OR

  • eight (8) or more years of qualifying professional experience

OR

  • an equivalent combination of education and work experience may be considered

Desirable Qualifications:

  • A master's degree in one of the following: public health, business administration or public policy

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.

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