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Division of TennCare

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TennCare Project Manager

Division of TennCare

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Job Summary

TennCare is made up of the Tennessee Medicaid program, the Office of eHealth Initiatives, the Strategic Planning Initiatives Group and Cover Tennessee. TennCare’s Office of General Counsel (OGC) is responsible for providing legal advice and counsel to all divisions of TennCare. This Project Manager position is a newly formed position that will be in OGC’s Third Party Liability (TPL) unit.  TPL refers to the legal obligation of third parties (for example, certain individuals, entities, insurers, or programs) to pay part or all the expenditures for assistance furnished under a State Medicaid or CHIP program.  The obligations are referred to as Third Party Resources (TPRs). By law, all TPRs must meet their legal obligation to pay claims before the Medicaid or CHIP program pays. The division of TennCare must take all reasonable measures to ascertain the legal liability of third parties to pay for care and services that are available to TennCare and CoverKids members.

Job Responsibilities

• Oversee TPL reporting from TennCare partners (including Managed Care Organizations, Pharmacy and Dental Benefits Managers, and other contractors)
• Design report templates
• Compile and analyze reports
• Monitor compliance with reporting requirements
• Liaise with TennCare partners regarding reporting and other TPL matters
• Design database for centralized compilation of TPL information
• Oversee the design and implementation of data-driven process improvements
• Estimate the cost, savings, and impact of proposed TPL improvements
• Prepare reports for senior management detailing the risks and benefits of proposed improvements
• Participate in meetings with TennCare partners and internal staff regarding TPL

Qualifications

• Strong analytical skills with ability to translate data analysis into business recommendations
• Ability to balance strong data analytics skills with a strategy-oriented mindset
• Bachelor’s degree from an accredited university in relevant quantitative field (Mathematics/Statistics, Computer Science, Engineering)
• One or more years experience with relational databases and SQL
• Ability to communicate complex quantitative analysis in a clear, precise and actionable manner
• A strong passion for empirical research and for answering hard questions with data
• Ability to work independently and problem solve

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: Other
  • Service Area: Government