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TennCare

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Tennessee Health Link Lead

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 Division. A key responsibility of the 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 divisions 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.

Job Responsibilities

RESPONSIBILITIES

  • Provide program oversight
    • Maintain and provide quality assurance support for program documents (i.e., provider reports, report templates, Detailed Business Requirements, Provider Operating Manual, etc.)
    • Develop and maintain strong partnerships with stakeholders including providers, vendors, managed care staff, and external groups
    • Develop and coordinate official communication to THL providers as needed
    • Develop and present content for stakeholder meetings and calls
  • Provide oversight of THL Organizational coaching efforts by the MCOs
    • Participate in monthly MCO Coaching calls to discuss onsite educational support to providers
    • Communicate with MCOs to align on coaching and monitoring of THL organizations
    • Work in collaboration with the internal staff on coaching support for the program
    • Frequently participate in coaching sessions and/or Engagement Evaluation meetings with the MCO and provider
  • Additional support and responsibilities
    • Attend provider conferences in Tennessee throughout the year
    • Assist in ad hoc projects and requests from internal and external customers
    • Collaborate with the Patient Centered Medical Home (PCMH) program as needed and other TennCare initiatives and programs
    • Liaison for THL to the Care Coordination Tool and the eHealth team
    • Coordinate with data analytics staff to monitor trends within the THL program

Qualifications

MINIMUM QUALIFICATIONS

  • A master’s degree in public health, healthcare administration, or related field and 2+ years full time professional experience in a healthcare setting or coordinating the implementation of health programs — OR—
  • A master’s degree in psychology, counseling, social work or related field and 5+ years full time professional experience in a behavioral health setting or coordinating the implementation of health programs
  • Strong organizational skills, including the ability to prioritize multiple projects
  • Ability to work well with multiple teams and stakeholders
  • Excellent communication, collaborative and presentation skills

DESIRABLE QUALIFICATIONS

  • Experience working in the Tennessee community behavioral health system
  • Knowledge of HEDIS measures and thresholding
  • Intermediate to advanced Excel skills with the ability to analyze and summarize report data
  • Ability to work independently and collaborate and communicate with important stakeholders;
  • Proficiency in Microsoft Office software including Word, Excel, and PowerPoint;
  • Demonstrated time management skills and proven ability to manage multiple tasks simultaneously while completing work within allocated time frames.
  • Working clinical knowledge of mental health and substance use disorder services
  • Experience with policy development and policy analysis, especially with TennCare policies
  • Demonstrated management and leadership skills; ability to work independently with minimum supervision
  • Ability to represent TennCare in a professional manner; strong communication skills with the ability to participate and/or facilitate interdepartmental and community meetings

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: November 5, 2020
  • Type: Full-Time
  • Job Function: Executive Leadership
  • Service Area: Government