Eligibility Specialist for Waiver Programs

2 weeks ago


Nashville, Tennessee, United States State of Tennessee Full time
Position Overview:

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.



  • Nashville, Tennessee, United States State of Tennessee Full time

    Position Overview:The State of Tennessee is looking for a dedicated individual to fill the role of Waiver Programs Eligibility Specialist within the Member Services division of TennCare.This position will be integral to the Eligibility Operations Group, reporting directly to the Group Manager.Key Responsibilities:Assess and review all submitted documentation...


  • Nashville, Tennessee, United States State of Tennessee Full time

    Executive Service WAIVER PROGRAMS ELIGIBILITY SPECIALIST The Division of TennCare is committed to fostering a flexible work environment. All positions within TennCare offer a blend of remote and in-office work, tailored to the specific role, department, and operational requirements. Detailed expectations will be discussed during the hiring process. About Us:...


  • Nashville, Tennessee, United States State of Tennessee Full time

    Job OverviewThe State of Tennessee is seeking a qualified candidate for the position of Eligibility Programs Specialist within the TennCare department. This role involves significant responsibilities in managing and overseeing eligibility processes related to healthcare programs.Key Responsibilities1. **Resource Management**: Ensure compliance with policies...


  • Nashville, Tennessee, United States State of Tennessee Full time

    Position Overview State of Tennessee Employment Opportunity This role involves significant responsibility in overseeing complex eligibility processes within the TennCare program. The successful candidate will engage in high-level professional work that requires analytical skills and the ability to manage a team effectively. Key Responsibilities Resource...


  • Nashville, Tennessee, United States State of Tennessee Full time

    Position Overview Organization: State of Tennessee Role Summary: This position entails significant professional responsibilities within the TennCare program, focusing on the assessment and management of eligibility criteria. The role involves both technical and supervisory duties, ensuring compliance with established policies and procedures. Key...


  • Nashville, Tennessee, United States Tennessee Full time

    Tax Relief SpecialistAbout Our OfficeThe Office of the Tennessee Comptroller of the Treasury oversees the auditing of state and local governmental entities while engaging in the overall financial and administrative management of state operations.Led by Comptroller Jason E. Mumpower, who is elected by the Tennessee General Assembly, our office is dedicated to...

  • Program Facilitator

    7 days ago


    Nashville, Tennessee, United States The GEO Group, Inc. Full time

    About The GEO Group, Inc.The GEO Group, Inc. is a leading provider of correctional and community reentry services. Our mission is to provide safe, secure, and rehabilitative environments that support the successful reintegration of individuals into their communities.Job SummaryThe Program Facilitator - Rehabilitation Specialist will play a critical role in...


  • Nashville, Tennessee, United States Amazon Full time

    Join Our Team as a Senior Program Management SpecialistAre you an experienced Program Manager with a passion for leading large-scale, cross-organizational initiatives that drive significant business and technical outcomes? If you thrive in a dynamic and rapidly growing global environment, we have an exciting opportunity for you. The AmazonFresh Merchant...


  • Nashville, Tennessee, United States Oasis Center Full time

    Job SummaryWe are seeking a highly motivated and experienced Youth Program Specialist to join our team at Oasis Center. The successful candidate will be responsible for coordinating and facilitating direct-to-youth programming, community efforts, and administrative tasks.Key ResponsibilitiesProgram Development: Plan and implement weekly in-person drop-in...


  • Nashville, Tennessee, United States Duke International for State of Tennessee Full time

    Position: Managed Care Specialist Location: Nashville, TN Key Responsibilities · Assess eligibility for care programs tailored to individual and family needs. · Facilitate and streamline communication and scheduling between internal and external stakeholders. · Conduct thorough client interviews, gather pertinent information, and compile case...


  • Nashville, Tennessee, United States RadGov Inc. Full time

    Position: Managed Care SpecialistLocation: Nashville, TNContract Duration: 12+ monthsOverview:This role is strictly onsite in downtown Nashville, TN. Candidates must be local to the area.RadGov Inc. is seeking a Managed Care Specialist for an essential onsite position. This role is critical in ensuring effective communication and coordination within our...


  • Nashville, Tennessee, United States Restore Hyper Wellness - RHWM036 Full time

    Job OverviewHealth & Wellness SpecialistAt Restore Hyper Wellness, we embrace the concept of Hyper Wellness, which reflects our commitment to providing innovative services that yield tangible results. Our mission is to enhance our clients' well-being with every visit, activating their body's natural defense systems. Hyper Wellness is not just a service; it...


  • Nashville, Tennessee, United States Safe Step Walk-In Tub Co. Full time

    About the RoleSafe Step Walk-In Tub Company is seeking a highly skilled Credit Coordinator to join our team. As a key member of our finance department, you will be responsible for managing credit accounts, processing payments, and resolving customer inquiries.Key ResponsibilitiesCredit Account Management: Work with credit accounts, following established...


  • Nashville, Tennessee, United States Green Hills Center for Rehabilitation and Healing Full time

    Rehabilitation SpecialistSign-On Bonus AvailableThe Green Hills Center for Rehabilitation and Healing is in search of a dedicated Rehabilitation Specialist to join our team. We offer both Full-Time and PRN opportunities.Key Responsibilities:The Rehabilitation Specialist will conduct comprehensive assessments of patients referred for rehabilitation services....


  • Nashville, Tennessee, United States Tennessee Full time

    Tax Relief Analyst About Our Office The Office of the Tennessee Comptroller of the Treasury oversees the auditing of state and local governmental entities while playing a vital role in the financial and administrative management of state operations. Led by Comptroller Jason E. Mumpower, who is elected by the Tennessee General Assembly, our office is...


  • Nashville, Tennessee, United States Musicians Institute Full time

    Job OverviewMusicians Institute is a vibrant institution dedicated to contemporary music education. We focus on nurturing the talents of aspiring musicians and industry professionals. Our Guitar Craft Academy, located in Nashville, TN, specializes in training students to become skilled luthiers, equipping them with the essential techniques to design,...


  • Nashville, Tennessee, United States Center for Watershed Protection Full time

    About the RoleThe Center for Watershed Protection is seeking a highly skilled Public Works Specialist to provide expert advice and technical assistance to our clients. As a Public Works Specialist, you will serve as a subject matter expert, providing professional guidance and support on public works, utilities, and engineering issues.Key...


  • Nashville, Tennessee, United States Nashville Center For Rehabilitation and Healing Full time

    Nashville Center For Rehabilitation and Healing is actively seeking a dedicated Full-Time and PRN Rehabilitation Specialist (Physical Therapist) to become a vital part of our team. We are pleased to offer a Sign-On Bonus along with Daily Pay options for this role.Position Overview:We are in search of a licensed Rehabilitation Specialist who will assist...


  • Nashville, Tennessee, United States Center for Nonprofit Management Full time

    Job SummaryThe Center for Nonprofit Management seeks a skilled Volunteer Program Manager to oversee the development and implementation of volunteer programs that benefit older adults and adults with disabilities. This is an exciting opportunity to join a dynamic team and make a meaningful impact in the community.Key ResponsibilitiesDevelop and implement...


  • Nashville, Tennessee, United States Center for Nonprofit Management Full time

    Job SummaryThe Center for Nonprofit Management seeks a skilled Volunteer Program Coordinator to oversee the development and implementation of volunteer programs that benefit older adults and adults with disabilities. This is an exciting opportunity to make a meaningful impact in the community while working with a dynamic team.Key ResponsibilitiesDirect the...