Current jobs related to Eligibility Programs Specialist - Nashville, Tennessee - State of Tennessee
-
Billing and Eligibility Specialist
2 weeks ago
Nashville, Tennessee, United States Lucent Health Solutions, Inc. Full timeAbout Lucent Health Solutions, Inc.We are a leading provider of healthcare benefits solutions, combining top-tier claims management with a compassionate, human-focused, data-driven care management approach. Our goal is to help self-insured employers provide care management that enables health plan participants to make informed, cost-saving healthcare...
-
Nashville, Tennessee, United States OneOncology Full timeJob Title: Senior Eligibility Verification and Benefit SpecialistOneOncology is a leading provider of cancer care services, and we are seeking a highly skilled Senior Eligibility Verification and Benefit Specialist to join our team. As a key member of our team, you will play a critical role in ensuring that our patients receive the best possible care by...
-
Nashville, Tennessee, United States OneOncology Full timeJob Title: Senior Eligibility Verification and Benefits SpecialistOneOncology is a leading provider of cancer care services, and we are seeking a highly skilled Senior Eligibility Verification and Benefits Specialist to join our team. As a key member of our operations team, you will play a critical role in ensuring that our patients receive the best possible...
-
Mental Health Program Specialist
2 weeks ago
Nashville, Tennessee, United States Lorven Technologies Full timeJob Title: Mental Health Program SpecialistLorven Technologies is seeking a highly skilled Mental Health Program Specialist to join our team. As a key member of our organization, you will play a critical role in developing and implementing programs related to dementia education within the aging network.Key Responsibilities:Act as a liaison and point of...
-
Administrative Support Specialist
1 week ago
Nashville, Tennessee, United States 22nd Century Technologies Full timeJob Title: Administrative Specialist/Admin Assistant (HYBRID)Job Summary:22nd Century Technologies is seeking a highly skilled Administrative Specialist/Admin Assistant to join our team. As a key member of our organization, you will be responsible for determining individual and family eligibility for our Client's care programs, coordinating and communicating...
-
Managed Care Specialist
2 weeks ago
Nashville, Tennessee, United States Lorven Technologies Full timeJob Title: Managed Care SpecialistLorven Technologies is seeking a highly skilled Managed Care Specialist to join our team. As a key member of our team, you will be responsible for determining individual and family eligibility for our client's care programs.Key Responsibilities:Eligibility Determination: Determine individual and family eligibility for our...
-
Healthcare Operations Specialist
2 weeks ago
Nashville, Tennessee, United States CTD Staffing, LLC Full timeh3Job Description/h3pCTD Staffing, LLC is seeking Administrative/Case Management/Data Entry candidates to fill positions with a large client in the Nashville area./ppThe position involves case management and eligibility determining activities for a statewide program. The official title is "Managed Care Specialist"./ppKey responsibilities include processing...
-
Nashville, Tennessee, United States State of Tennessee Full timeJob InformationJob Title: Intellectual and Developmental Disabilities Program Specialist 3Job Summary: We are seeking a highly skilled and experienced Program Specialist 3 to join our team in the Intellectual and Developmental Disabilities (IDD) department. The successful candidate will be responsible for providing technical assistance to program providers,...
-
Managed Care Specialist
6 days ago
Nashville, Tennessee, United States Integrated Resources Full timeJob Title: Managed Care SpecialistJob Summary:Integrated Resources is seeking a highly skilled Managed Care Specialist to join our team. As a key member of our team, you will be responsible for determining individual and family eligibility for our client's care programs. Your excellent communication and organizational skills will enable you to effectively...
-
Managed Care Specialist
2 weeks ago
Nashville, Tennessee, United States Integrated Resources Full timeJob Title: Managed Care SpecialistLocation: Nashville, TN (Hybrid)Duration: 12 MonthsJob Description:We are seeking a highly skilled Managed Care Specialist to join our team at Integrated Resources. As a key member of our team, you will be responsible for determining individual and family eligibility for our client's care programs.Key...
-
Cardiovascular Specialist
3 weeks ago
Nashville, Tennessee, United States Nashville General Hospital Full timeJob Title: Cardiovascular SpecialistNashville General Hospital is seeking a skilled Cardiovascular Specialist to join our team. As a Cardiovascular Specialist, you will be responsible for providing high-quality patient care and contributing to the advancement of cardiology.Responsibilities:Patient Care: Conduct thorough evaluations of patients with...
-
Fitness Program Manager
2 months ago
Nashville, Tennessee, United States Crunch - Fitness Gurus Full timeJob Summary:The Personal Training Manager is a key role at Crunch - Fitness Gurus, responsible for maximizing member participation in our paid Personal Training Services. This involves meeting and exceeding new client acquisition and existing client retention goals.Key Responsibilities:Sales and Coaching: Manage and coach the front-end selling process of the...
-
Nashville, Tennessee, United States ADDICTION AND MENTAL HEALTH SERVICES, LLC Full timeJob DescriptionWe are seeking a dedicated and passionate professional to join our team as an Addiction Treatment Therapist for our PHP Program.Key Responsibilities:Conduct comprehensive Psychosocial Assessments and develop treatment plans with specific goals and objectives.Evaluate and integrate assessment findings into clinical summaries and manage patient...
-
Tutor, K-8 After School Programs Specialist
6 days ago
Nashville, Tennessee, United States Martha Obryan Center Full timeJob OverviewWe are seeking a dedicated and passionate individual to join our team as a Tutor, K-8 After School Programs Specialist. In this role, you will provide academic support and guidance to students in grades K-8, helping them to achieve their full potential.Key Responsibilities:Develop and maintain positive relationships with students, fostering a...
-
Sleep Medicine Specialist
6 days ago
Nashville, Tennessee, United States Vanderbilt University Medical Center Full timeAbout the Role:We are seeking a highly motivated and skilled Sleep Medicine Specialist to join our team at Vanderbilt University Medical Center. As a key member of our Division of Sleep Medicine, you will work collaboratively with a multidisciplinary team of neurologists, pediatricians, pulmonologists, and advanced practice providers to provide exceptional...
-
Nurse Resident Program
2 weeks ago
Nashville, Tennessee, United States Williamson Health Full timeProgram OverviewThe Nurse Resident Program at Williamson Health is designed to provide new nurses with the skills and knowledge necessary to excel in their clinical roles. The program aims to build on the graduate nurse's skills related to clinical judgment and performance, while also providing clinical nursing leadership at the point of care.Program...
-
Nurse Resident Program
1 month ago
Nashville, Tennessee, United States Williamson Health Full timeProgram Overview At Williamson Health, we are committed to providing a comprehensive Nurse Resident Program that supports the growth and development of our new graduate nurses. **Program Design:** Our program is designed to help you build on your clinical judgment and performance skills, provide clinical nursing leadership at the point of care, and...
-
Managed Care Specialist
2 weeks ago
Nashville, Tennessee, United States Lorven Technologies Full timeLorven Technologies is seeking a highly skilled Managed Care Specialist to join our team. As a key member of our organization, you will play a critical role in determining individual and family eligibility for our Client's care programs. Your responsibilities will include coordinating and communicating schedules to internal and external clients, conducting...
-
Cardiac Care Specialist
2 weeks ago
Nashville, Tennessee, United States Nashville General Hospital Full timeJob SummaryNashville General Hospital is seeking a highly skilled Registered Nurse to join our Cardiac/Telemetry Unit. As a key member of our team, you will be responsible for providing exceptional patient care and working collaboratively with our multidisciplinary team to achieve optimal patient outcomes.Key ResponsibilitiesAdmit and assess patients,...
-
Data Entry Specialist
2 weeks ago
Nashville, Tennessee, United States Insight Global Full timeJob Title: Data Entry SpecialistWe are seeking a highly skilled Data Entry Specialist to join our team at Insight Global. As a Data Entry Specialist, you will be responsible for extracting information from multiple databases and assisting in determining individual and family eligibility for care.Job Summary:This is a contract position for 12 months with an...
Eligibility Programs Specialist
2 months ago
Executive Service
WAIVER PROGRAMS ELIGIBILITY SPECIALISTThe 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:
TennCare serves as Tennessee's managed care Medicaid initiative, delivering health insurance to various low-income demographics, including expectant mothers, children, caregivers of young children, senior citizens, and adults with physical disabilities. Covering approximately 1.7 million residents, TennCare operates with an annual budget nearing $14 billion. The program is managed by the Division of TennCare, under the supervision and partial funding of the Centers for Medicare and Medicaid Services (CMS). Our mission is to enhance the quality of life for Tennesseans through the provision of high-quality, cost-effective healthcare. We empower our workforce to engage actively and collaborate effectively to refine organizational processes, ultimately making a positive impact on our members' lives. Our employees frequently express that their roles provide them with significant meaning, purpose, and fulfillment. Leadership at TennCare recognizes that our employees are our greatest asset, prioritizing their professional and leadership development.
Position Overview:
The Division of TennCare is in search of a Waiver Programs Eligibility Specialist to join the Eligibility Operations Group within Member Services. This role will report to an Eligibility Operations Group Manager. The primary responsibility involves processing applications in TEDS to ascertain eligibility for Institutional Medicaid. The specialist will engage with clients, families, facilities, and Authorized Representatives to communicate clear requirements and expectations for accurate eligibility assessments. Furthermore, documentation of actions in TEDS and other relevant systems will be necessary.
Key Responsibilities:
- Assess all submitted documents and make eligibility determinations in compliance with applicable rules, regulations, policies, and guidelines.
- Timely process Medicaid applications in accordance with established policies and regulations.
- Offer support and guidance to team members regarding Medicaid rules, regulations, policies, procedures, and organizational databases.
- Monitor production to ensure accuracy and adherence to production standards.
- Facilitate and participate in training sessions, providing resources and tools to enhance staff performance and professional growth.
- Deliver exceptional customer service to both internal and external stakeholders.
Minimum Qualifications:
Education and Experience:
- Bachelor's degree from an accredited institution in a relevant field (preferably in business administration, management, public health, health policy, paralegal, or legal assistant studies) along with two years of pertinent work experience.
- Alternatively, a combination of education and relevant work experience may be considered.
Essential Skills:
- Ability to cultivate and sustain collaborative working relationships.
- Capacity to adapt to shifting priorities and deadlines.
- Proficient in exercising sound judgment.
- Strong organizational skills, including the ability to prioritize, multitask, and manage workload effectively.
- Advanced writing and communication abilities.
Desirable Qualifications:
- Bachelor's degree from an accredited institution in business administration, management, public health, or health policy, along with four years of experience within TennCare or a Medicaid, managed care, or healthcare organization.
The State of Tennessee is dedicated to providing equal employment opportunities and maintaining a workplace free from discrimination and harassment based on race, color, national origin, age, sex, pregnancy, religion, creed, disability, veteran's status, or any other category protected by state and federal civil rights laws.
