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TennCare

Behavioral Health Program Manager

TennCare

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Job Summary

TENNCARE OVERVIEW

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 1.4 million Tennesseans and operates with an annual budget of approximately $12 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).

WHY WORK AT TENNCARE

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 work 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 AND DEPARTMENTAL OVERVIEW

Behavioral Health Operations is a critical team within the Managed Care Operations department. One key responsibility of this department is to monitor the behavioral health service array within TennCare. This team collaborates with various internal and external stakeholders to ensure members with behavioral health needs are receiving medically necessary care at the appropriate level.

Operationally, Behavioral Health Operations works closely with several TennCare departments to participate in the development and execution of a comprehensive quality strategy. Additionally, this team plays a strategic role in TennCare initiatives focused on improving clinical care and outcomes for TennCare members, including primary care transformation and population health. Behavioral Health Operations also works closely with TennCare’s contracted organizations and other state agencies to provide oversight of quality performance and data reporting for TennCare members.

Behavioral Health Program Manager
The Tennessee Health Link (THL) program is part of TennCare’s primary care transformation initiative. THL is an integrated value-based payment model designed to improve the quality of behavioral health services for TennCare members, the capabilities of and practice standards of behavioral health providers, and the overall value of health care delivered to the TennCare population.
The Behavioral Health Program Manager will serve as the lead for the THL program and will lead program implementation and strategy for THL. This position will engage with external stakeholders, including providers, managed care organizations, and other vendors.

Job Responsibilities

• Manage and oversee the Tennessee Health Link program
• Develop and manage external agency communications to THL providers
• Maintain quality assurance program such as; reports, templates, business requirements, operating manuals, etc.
• Enforce Contractor Risk Agreement (CRA) timelines and expectations
• Monitor MCOs THL coaching efforts via clinical documentation such as notes, semi-annual reviews, and coaching calls
• Assist in the planning and execution of the Delivery System Transformation Conferences
• Leading monthly MCO coaching calls and collaborating with MCOs to align on coaching strategies
• Collaborate with the Patient-Centered Medical Home (PCMH) program as needed and other TennCare initiatives and programs
• Coordinate with data analytics staff to monitor trends within the THL program• Supervise an Administrative Services Assistant, Managed Care Program Manager 2s, TennCare Program Coordinators, and indirectly supervise staff that could be comprised of Managed Care Specialists 3s, TennCare Program Coordinators, Managed Care Program Manager 1s, and other worker level staff

Qualifications

• A master’s degree in public health, healthcare administration, psychology, counseling, social work or related field
• 5+ years full time professional experience in a behavioral health setting or coordinating the implementation of health programs

Additional Information

Benefits

To see all the great benefits available to State of Tennessee employees, go to the TN.gov Benefits page:  https://www.tn.gov/hr/employees1/benefits.html

How to Apply

To apply for this job or see other opportunities at TennCare, visit the state of Tennessee’s Careers page today: https://www.tn.gov/careers/apply-here.html

Details

  • Date Posted: April 16, 2021
  • Type: Full-Time
  • Job Function: Clinician
  • Service Area: Government