REGULAR PROGRAMS ELIGIBILITY SPECIALIST - 07072026- 78869

Job Information Opening Date/Time: 07/07/2026 12:00AM Central Time Closing Date/Time: 07/20/2026 11:59PM Central Time Salary (Monthly): $3,631.00 Salary (Annually): $43,572.00 Job Type: Full-Time Location: Nashville, TN | Division: TennCare, Davidson County Position: Managed Care Specialist (Sub-series) Hybrid work environment with a combination of work from home and office. Position requires a criminal background check. Qualifications Education and Experience: Graduation from an accredited college or university with a bachelor's degree or two years of qualifying professional experience related to administrative, customer service and/or data entry positions associated with the application of policy or executing procedural provisions and/or eligibility within a health or healthcare, casework, or an insurance setting. Substitution of Experience for Education: Up to four years of relevant experience can substitute for education. Substitution of Experience for Education: Two years of full‑time work as a Managed Care Specialist with the State of Tennessee. Necessary Special Qualifications: Valid motor vehicle operator's license may be required. Overview Under general supervision, responsible for highly technical professional TennCare program work of considerable difficulty and/or supervisory work of average difficulty; and performs related work as required. The role may supervise a small to moderate sized unit of Managed Care Specialists and/or sub‑professional staff performing TennCare duties. Responsibilities Leads peers/subordinates in compiling information for initial processes for program participation related to application, appeals, recertifications, etc. Leads in preparation of provider rates, the analysis of data from contractors, processes specific enrollment information, and verifies accuracy of information. Leads peers/subordinates in documentation and storing enrollee and/or provider information in electronic databases and/or physical form to track appeals, monitoring information, and ensuring accurate information. Completes the performance management process for direct reports and provides feedback related to assigned tasks. Conducts/leads training as required. Coordinates workload of peers/subordinates with internal/external business partners as required to facilitate task completion. Follows policies and procedures and identifies inconsistencies and errors to suggest corrective action to management. Provides regular updates to upper management and other partners on the status of assigned work or assigned projects. Provides consultation and advice relating to federal and state health policies to internal/external partners, applicants, and other stakeholders. Networks with internal/external business partners and maintains open dialogue. Leads peer/subordinates to liaise with other entities to ensure processing of requests. Competencies (KSA's) Manages Complexity Organizational Savvy Directs Work Communicates Effectively Instills Trust Knowledge Communication and Media Administration and Management Customer and Personal Service Law and Government Education and Training Skills Active Learning and Listening Complex Problem Solving Judgment and Decision Making Monitoring Time Management Abilities Written Comprehension Inductive Reasoning Speech Clarity Oral Expression Problem Sensitivity Tools & Equipment Personal Computer Telephone Fax Machine Printer #J-18808-Ljbffr State of Tennessee