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Division of TennCare

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Statistical Research Specialist

Division of TennCare

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Job Summary

Operationally, the TennCare Member Medical Appeals (TMMA) Unit works closely with several other TennCare departments to help process TennCare member appeals for all eligible TennCare members to ensure they receive their medically necessary care.  Externally, the TMMA Unit works with TennCare’s managed care organizations and other state agencies to ensure the provision of covered medical, dental, behavioral health, and pharmacy services for TennCare members. This position will be a key member on the TMMA Data Analytics team, reporting to the TennCare Member Medical Appeals Unit Director.

Job Responsibilities

Administer reporting functionality and program evaluation for the TennCare Member Medical Appeals Unit.

  • Maintain updated knowledge of the Medical Appeals Tracking System (MATS) which is the appeals processing database and obtain required datasets and member information.
  • Perform statistical analyses and reporting on MATS data.
  • Use computer software (i.e., SAS, SPSS, Tableaus, Excel, or other specialized software related to area of study) to analyze data derived from MATS.
  • Compare results over time to show trends in data.
  • Analyze the derived data to develop templates to ensure daily, weekly, monthly, and quarterly reports are in accordance with departmental guidelines and to meet all internal, state, and federal reporting requirements.

Provide data visualization and in-depth analysis primarily through Microsoft Excel and Tableau to share key insights to Medical Office and MMA leadership, program staff, and external stakeholders at an appropriate level of audience understanding.

  • Track statistical data derived from MATS to determine appropriate policy recommendations for the unit.
  • Finalize formatted documents for electronic and/or other means of distributions to unit staff and management as requested.
  • Present relevant reporting information, both formally and informally, to small and large groups.
  • Create presentation-ready deliverables for internal and external stakeholders.
  • Manage special projects assigned by TMMA Unit Director and other members of management in the Chief Medical Office.

Ensure accuracy of automatically generated reports for all of the TennCare Member Medical Appeals Unit.

  • Perform quality assurance checks on all public-facing reports to ensure corrections have been made prior to distribution and to ensure accurate data measurement for documents generated within MATS.
  • Ensure corrections have been made to reports generated concerning documents received from each managed care organization that are uploaded into MATS.
  • Train users to become knowledgeable of and comfortable with final analytics deliverables.

Serve as the data analytics liaison to the continued development of the MATS system.

  • Provide analytics expertise to review and summarize complex reports for the TennCare Member Medical Appeals team and others upon request.
  • Represent all analytics needs for the unit, participate in ongoing development and design sessions, and ensure that required updates are included in the MATS system.
  • Ensure and provide oversight on the maintenance and structure of the MATS system to automate vital reporting components from MATS to achieve the required efficiency and compliance with federal and state requirements

Qualifications

Minimum Qualifications

A master’s degree in statistics, applied statistics, public health, health sciences, business, business administration, or public policy and experience equivalent to two years full-time professional work developing research methodology and/or performing statistical research and data visualization.
-OR-
A bachelor’s degree in statistics, applied statistics, mathematics, public health, health sciences, business, business administration, or public policy and experience equivalent to five years full- time professional work developing research methodology and/or performing statistical research and data visualization.

Substitution of Education for Experience: Additional graduate course work from an accredited college or university in statistics, applied statistics, social or behavioral sciences, health sciences, business, business administration, and/or public policy may substitute for the required experience on a year-for-year basis to a maximum of two years.

• Strong computer skills and data analytics skills including mastery of Microsoft Office (Excel, Access, Word, and PowerPoint)
• 2+ years performing data visualization in Tableau or related data visualization software
• Clear and concise oral and written communication skills
• Strong organizational skills, including the ability to prioritize, multi-task, and manage workload to meet specific timeframes and deadlines

Desirable Qualifications

• Experience with statistical analyses using SAS and/or SQL or other statistical software applications (R, Python, etc.)
• Experience in healthcare field and/or with quality measurement

Additional Information

Benefits

For more information about the great benefits available to State of Tennessee employees; click here:  https://www.tn.gov/hr/employees1/benefits.html

How to Apply

Please go to https://www.tn.gov/careers/apply-here.html. Search by “job title” or by “TennCare” to see all of our current job opportunities. Apply today!

Details

  • Date Posted: October 7, 2020
  • Type: Full-Time
  • Job Function: Analytics / Evaluation
  • Service Area: Government