Managed Care Specialist

Managed Care SpecialistTennCare 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) post-payment Utilization Reviews, update/analyze/validate federally mandated 1915(c) quality data on a monthly basis, and perform careful review and contribution to the upcoming 2025 1915(c) waiver renewals.Minimum QualificationsGraduation from an accredited college or university with a bachelor’s 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 skillsDesirable QualificationsPassion and commitment to supporting people with I/DD, person-centered practices, and integrated employment and community livingExperience with program management and/or grant managementExperience in contract managementExperience working in or with Medicaid or disability related programsStrong work ethic and self-motivated with ability to work well on a teamOrganizational skills, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlinesAbility to adapt to changing priorities and deadlines