Eligibility Specialist for Waiver Programs
2 weeks ago
The State of Tennessee is seeking a dedicated individual for the role of Waiver Programs Eligibility Specialist within the Member Services department. This position is integral to the Eligibility Operations Group and will report to the Eligibility Operations Group Manager.
Role Responsibilities:
- Assess and process applications for Institutional Medicaid, ensuring compliance with all relevant rules and regulations.
- Communicate effectively with clients, families, facilities, and Authorized Representatives to clarify the information required for accurate eligibility assessments.
- Maintain thorough documentation of actions taken in the TEDS and other relevant systems as necessary.
Key Duties:
- Review submitted documents to determine eligibility based on established guidelines.
- Ensure timely processing of Medicaid applications in accordance with policies.
- Provide guidance and support to team members regarding Medicaid regulations and procedures.
- Monitor production accuracy and adherence to performance standards.
- Facilitate training and development opportunities for staff to enhance their skills and knowledge.
- Deliver exceptional customer service to both internal and external stakeholders.
Qualifications:
- A bachelor's degree from an accredited institution in a relevant field such as business administration, public health, or legal studies, along with two years of pertinent experience.
- Alternatively, a combination of education and experience may be considered.
- Strong interpersonal skills with the ability to build effective working relationships.
- Adaptability to shifting priorities and deadlines.
- Excellent organizational abilities, including prioritization and multitasking skills.
- Proficient writing and communication skills.
Preferred Qualifications:
- A bachelor's degree in business administration, management, public health, or health policy, along with four years of experience in TennCare or a similar Medicaid, managed care, or healthcare organization.
The State of Tennessee is committed to providing equal employment opportunities and fostering a workplace free from discrimination and harassment.
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