Customer Care Representative

Requisition Name: Managed Care Specialist/ Customer Care Representative

Job Type: Full-Time Contract (12 Months, with strong potential for extension)

Location: Nashville, TN (Hybrid – Downtown Nashville)

Work Schedule: Monday – Friday, 7.5 hours/day (37.5 hours/week)

Training: Up to 6 weeks of comprehensive initial training (virtual/on-site as designated; 100% daily attendance required, no pre-planned PTO permitted during training)

Job Overview

We are seeking an analytical, detail-oriented Managed Care & Casework Specialist to join our team in a hybrid capacity based in Nashville, TN. This role bridges healthcare program eligibility, customer advocacy, and quasi-legal case coordination.

The ideal candidate will manage program eligibility reviews, conduct structured client interviews, compile comprehensive case documentation, perform basic legal and policy research, and prepare findings for legal and program leadership review.

Key Responsibilities

• Eligibility & Program Assessment: Evaluate and determine individual and family eligibility for designated healthcare and managed care assistance programs.
• Client Interviews & Fact-Finding: Conduct structured intake interviews with applicants, collect supporting records, verify data accuracy, and summarize case details.
• Legal Support & Documentation: Perform foundational legal and regulatory research, review legal papers, and assist in drafting summary documents and case recommendations for review by legal counsel.
• Case Management: Maintain end-to-end casework tracking, ensure strict adherence to turnaround deadlines, and accurately log all actions and resolutions in record databases.
• Systems & Data Navigation: Seamlessly navigate multiple proprietary databases and management systems to retrieve, extract, and reconcile information.
• Coordination & Communication: Act as a key point of contact for internal teams and external program participants to relay program guidelines, schedules, and status updates.
• Team Collaboration: Actively participate in departmental workgroup meetings, report on case trends, and assist leadership with ad-hoc projects.

Required Qualifications

• Education: Associate or Bachelor’s degree from an accredited institution.
• Location & Availability: Must be local to Middle Tennessee and able to commute to the downtown Nashville office per hybrid schedule guidelines.
• Technical Skills: Strong proficiency across Microsoft Office Suite (Word, Excel, Outlook, PowerPoint, SharePoint) and comfortable navigating complex databases.
• Communication: Superior verbal and written communication skills suitable for conducting professional interviews and drafting clear legal/case summaries.
• Organization & Detail: Exceptional time-management, note-taking, and prioritization skills with a proven track record of handling high-volume documentation under tight deadlines.

Preferred Qualifications

• Educational background in Paralegal Studies , Legal Studies, or Criminal Justice.
• Prior experience working in a legal, court, regulatory, or compliance office environment.
• Previous experience in high-touch customer support, contact centers, or public assistance eligibility determinations.