Job Information
State of Tennessee Job Information
Opening Date/Time
Thur 05/25/2023 12:00AM Central Time
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Closing Date/Time
Wed 06/07/2023 11:59PM Central Time
Salary (Monthly)
$4,450.00
Salary (Annually)
$53,400.00
Job Type
Full-Time
City, State Location
Statewide
Department
TennCare
LOCATION OF (1) POSITION(S) TO BE FILLED: DIVISION OF TENNCARE, TENNCARE DIVISION, STATEWIDE
TennCare compensation is equitable and will be based on education and experience for a qualified candidate in accordance with Department of Human Resources (DOHR) policy. This position requires a background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.
The Division of TennCare is dedicated to providing our employees with a hybrid work environment. All TennCare positions have a combination of work from home and work in the office, which varies by position, department, and business need. You may review the specific expectations with our hiring team.
Minimum Qualifications
Education and Experience: Graduation from an accredited college or university with a bachelor's degree and experience equivalent to five years of professional level experience interpreting policy or procedural provisions for a TennCare, Medicaid, Managed Care, or other related health insurance organization, of which one year must include drafting contractual requirements, developing rules and regulations, or supervising professional staff who deal with health insurance.
Substitution of Experience for Education: Qualifying professional experience interpreting policy or procedural provisions for a related health insurance organization may substitute for the required education to a maximum of four years (e.g., experience equivalent to one year of full-time work in one or a combination of the above listed fields may substitute for one year of the required education).
OR
Four years of full-time work as a Managed Care Specialist, Managed Care Program Mgr, and/or Managed Care Division Director with the State of Tennessee, of which one year must be at the Managed Care Specialist 3 or higher level.
Other Requirements
Necessary Special Qualifications: None.
Examination Method: Education and Experience,100%, for Preferred Service positions.
Examination Method: Education and Experience,100%, for Preferred Service positions.
Job Overview
Summary: Under general supervision, is responsible for professional managerial and supervisory work of average difficulty; and performs related work as required.
Distinguishing Features: An employee in this class is responsible for managing a moderate sized section which is assigned complex duties. This class differs from that of Managed Care Specialist 3 in that an incumbent of the latter functions at a highly technical professional level or supervises a small to moderate sized section which is assigned duties of routine to average complexity. This class differs from that of Managed Care Program Mgr 2 in that an incumbent of the latter is responsible for assisting in directing the activities and services of a most complex division or manages a large and/or most complex section.
Work Activities
Interacting With Computers:
- Uses appropriate database tracking software specific to the state and agency, as required.
- Uses office productivity software including but not limited to word processing programs, spreadsheet programs, presentation software, web-based email programs, instant messaging programs, and search engines.
Developing Objectives and Strategies:
- Develops job plans for assigned subordinates to communicate responsibilities and expected outcomes of performance in their role.
- Develops strategies and objectives for assigned program areas to enhance performance and improve organizational efficiency.
- Develops strategies for addressing staffing and headcount needs to ensure adequate coverage for assigned workload.
- Continually documents the performance of assigned subordinates to ensure accurate and unbiased performance evaluations.
- Documents investigations performed for employee relations purposes to ensure accurate information is used in decision making.
- Identifies changes to policies to update standard operating procedures and ensure that the team's work is in compliance with the most current standards.
- Identifies work priorities to ensure the most important work is completed first based on work experience, supervisor guidance, and departmental, state, and federal laws, rules, regulations, and guidelines.
- Selects job candidates who best fit available positions based on the results of selection assessment and testing.
- Approves, directly or tacitly, all transactions completed by assigned subordinates to ensure accuracy and compliance with standards.
- Approves or denies performance evaluations on behalf of the appointing authority to ensure compliance with standards.
- Audits transactions completed by assigned subordinates to ensure accuracy and compliance with standards prior to approval.
- Evaluates production of assigned subordinates to ensure accuracy and that production standards are met.
- Evaluates candidate and employee qualifications to determine compliance with minimum qualifications and/or necessary and special qualifications.
- Interprets a variety of current rules, regulations, policies, procedures, and documentation for internal and external business partners to facilitate understanding, enhance communications, and ensure compliance.
- Explains program specific procedures and regulations to persons in other departments or divisions, or outside organizations and representatives, as required.
- Monitors error reports for accuracy.
- Reviews the work of assigned subordinates to provide assistance and guidance on proper order and completion.
- Monitors time and labor during each pay period to identify timekeeping issues and exceptions.
- Monitors production quotas for assigned subordinates to ensure that required quotas are met.
- Assesses the performance of assigned subordinates to inform the performance evaluation process.
- Assesses the quality of the work of assigned subordinates to inform advice and guidance related to performance management and development.
- Assesses employee disciplinary and performance evaluation documentation to inform recommendations to management.
- Assesses candidate applications to determine qualifications and inform decisions on who should be interviewed and what salary should be offered.
- Resolves disciplinary actions of assigned subordinates.
- Resolves interpersonal conflicts between assigned subordinates to ensure a respectful and productive work environment.
- Resolves simple conflicts without supervisory input to ensure timely and efficient performance and maintain positive working relationships.
- Maintains a respectful and productive work environment within the assigned work unit to minimize disputes and facilitate performance.
- Directs complex or difficult to resolve conflicts to assigned supervisor, as required.
- Coordinates with upper management, peers, and assigned subordinates to facilitate workload assignments for the purpose of timely and accurate task completion.
- Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
- Completes performance evaluation documentation for all assigned subordinates.
- Maintains confidential reports, files, and logs as required to ensure compliance with departmental, state, and federal laws, rules, regulations, and best practices.
- Enters personal time and leave/overtime requests into the appropriate databases, as required.
- Responds to emails, phone calls, and other correspondence as required.
- Organizes and prioritizes personal workload and the workloads of assigned subordinates using calendars, lists, and other facilitators to ensure timely and accurate completion of work.
- Incorporates last minute and unscheduled tasks into current workload to ensure timely and accurate completion of work.
- Delegates tasks to assigned subordinates based on their competencies to ensure work is completed accurately, efficiently, and timely.
- Contacts vendors and other outside agencies to obtain/provide required information, correct errors, and/or for clarification purposes.
- Communicates with outside callers to obtain/provide required information, correct errors, and/or for clarification purposes.
- Networks with internal and external business partners to ensure open dialogues exist and to facilitate coordination and unified effort.
- Maintains professional working relationships with peers, with assigned subordinates, and with upper management to ensure smooth and effective team operations.
- Develops spreadsheets, presentations, forms, memos, database queries, logs, and other systems as required to facilitate accurate data gathering, tracking, training, and dissemination.
- Incorporate departmental, state, and federal laws, rules, regulations, and policies into team best practices and standard operating procedures for efficiency and compliance purposes.
- Develops process improvement suggestions to streamline workflow and improve productivity and accuracy.
- Participates in brainstorming sessions to develop process streamlining initiatives and improve business practices.
- Provides information to supervisors, coworkers, and subordinates by telephone, in written form, email, or in person.
- Conducts periodic performance development meetings with assigned subordinates to communicate and develop job plans and provide performance feedback and developmental guidance.
- Provides regular updates to upper management and other internal business partners on the status of projects and other assigned work.
- Communicates with assigned supervisor to ensure accurate and timely receipt of instructions and work assignments.
- Maintains an open dialogue with internal partners to ensure effective and efficient communications.
- Participates in staff meetings as required to provide and gather status updates for assigned workload.
- Leads assigned subordinates in handling complaints, settling disputes, and resolving grievances and conflicts, and otherwise negotiating with others.
- Leads assigned subordinates in developing constructive and cooperative working relationships with others and maintaining them over time.
- Leads assigned subordinates in getting members of a group to work together to accomplish tasks.
- Leads assigned subordinates in monitoring and reviewing information from materials, events, and the environment to detect and assess problems.
- Leads assigned subordinates in identifying the educational needs of others, developing training programs and classes, and teaching and instructing others.
- Leads assigned subordinates in performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
- Leads assigned subordinates in scheduling events, programs, and activities, as well as the work of others.
- Leads assigned subordinates in entering and maintaining information in written and electronic form.
- Identifies the developmental needs of others and coaches, mentors, or otherwise helps others to improve their knowledge or skills.
- Encourages and builds mutual trust, respect, and cooperation among team members.
- Schedules personal workload and the workloads of assigned subordinates to ensure timely processing and account for current workload.
- Schedules deadlines for subordinates to ensure timely submission of required information.
- Schedules training, orientations, meetings, and projects, as required.
- Notifies supervisory personnel of possible violations of departmental, state, and federal laws, rules, regulations, guidelines, policies, and procedures.
- Makes recommendations for changes in operations, efficiency and quality of agency operations and services.
- Advises peers and/or assigned subordinates on proper departmental procedures related to the accomplishment of their daily workload.
- Assists assigned subordinates in resolving processing problems to enhance development and team performance.
- Obtains information regarding enrollees through multiple media for processing or distribution to subordinates.
- Receives production and error reports from staff and multiple computer systems to maximize productivity and minimize errors.
- Receives information from accounting personnel and program personnel through email in order to develop budgets and contracts.
- Receives invoices related to contracts through mail for review and to ensure accuracy.
- Recruiting, interviewing, selecting, hiring, and promoting employees in an organization.
- Actively seeks out work related to developmental opportunities for self and assigned subordinates to improve performance and team efficiency.
- Periodically reviews current departmental, state, and federal information sources to identify relevant changes in policies, procedures, rules, regulations, and best practices.
- Attends agency specific training as required to ensure compliance with departmental, state, and federal laws and guidelines.
- Attends in-service training as required to ensure continual learning and current knowledge of the field.
- Analyzes production results over time to identify trends for staffing purposes and to ensure that enrollees receive the best possible services.
- Monitoring and controlling resources and overseeing the spending of money.
Competencies (KSA'S)
Competencies:
- Learning on the Fly
- Technical Learning
- Delegation
- Process Management
- Command Skills
- Managerial Courage
- Drive for Results
- Organizational Agility
- Approachability
- Building Effective Teams
Knowledge:
- Administration Management
- Education and Training
- Active Learning
- Active Listening
- Critical Thinking
- Speaking
- Instructing
- Complex Problem Solving
- Systems Evaluation
- Management of Personnel Resources
- Time Management
- Category Flexibility
- Deductive Reasoning
- Oral Comprehension
- Selective Attention
- Written Comprehension
- Written Expression
- Speech Clarity
Tools and Equipment Used
- Personal Computer
- Telephone
- Fax Machine
- Printer/Copier/Scanner
Other related office equipment as required
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