Attorney

Legal Review Attorney

To support an influx of eligibility appeals, the Legal Review Attorney unit is requesting additional support in the attorney capacity to ensure federal timeline requirements can continue to be met with high quality.

During an active assignment with the Division of TennCare, the selected attorney contractors may be prohibited from the practice of law outside of their TennCare assignment. This is due to potential conflicts of interest, etc. Please inform all candidates submitted.

This position is Hybrid - the number of office days / remote days will be determined by the TennCare unit.

Description of Duties:

• Research and review appeals in TennCare’s Tennessee Eligibility Determination System (TEDS) database and make a valid factual dispute determination. 25% of total work effort
• Acquire and maintain a thorough understanding of Medicaid statutes, regulations, and policies. 25% of total work effort
• Review and monitor cases and appeals to ensure they are processed in compliance with Medicaid statutes, regulations, and policies. 25% of total work effort
• Identify issues affecting eligibility determinations and appeals and propose remedial measures. 25% of total work effort

Minimum Qualifications:

• Bachelor’s Degree from an accredited college or university
• Juris Doctor from an accredited college or university
• Active License to practice law in Tennessee
• Ability to foster and maintain cohesive working relationships
• Ability to adapt to changing priorities and deadlines
• Ability to exercise sound judgment
• Excellent organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlines
• Excellent writing and communication skills required
• Ability to interpret and execute public policy
• Ability to interface with multiple computer systems and applications

Desirable Qualifications:

• Knowledge of and experience with eligibility appeals procedures a plus
• Previous legal review experience a plus

Location Requirements:

Candidate must be local. - Candidate Must Be Local

Additional Location Details (City, State):

Background Verification:

Minimum Verification Requirements - Please complete the following verification with Accurate/InfoCubic upon candidate's selection.

• TN Combined Counties & Statewide Search
• Address History Locator
• National Criminal Record Search
• Sex Offender Registry
• Criminal County & Statewide Search - 7 year search, based on residential address history
• Criminal Federal Search - 7 year search, based on residential address history
• Global Watch AKAs - Search current name and all additional names

Please review the comments section of this requisition for any additional background check requirements.