Appeals Litigation Manager - Hybrid Role

State of Tennessee; Nashville (TN); Hybrid; USD 56,000 - 68,000; Full time

Benefits offered by this job

Hybrid work environment

Job summary

The State of Tennessee's TennCare division seeks an Appeals Litigation Specialist Manager in Nashville to oversee a team of Litigation Specialists and support Medicaid eligibility appeals proceedings. Under the Appeals Litigation Specialist Director, you will guide staff on policy interpretation, ensure timely appeals processing, and collaborate with attorneys and internal units to improve outcomes.

This role requires strong leadership and excellent writing and communication skills in a hybrid

Qualifications

• Education and experience: bachelor's degree and five years of professional level experience interpreting policy or procedural provisions for TennCare, Medicaid, managed care, or related health insurance organization.
• Substitution of Experience for Education: five years of full-time work as a Managed Care Specialist/Manager with the State of Tennessee, at least one year at the Specialist 3 level.
• Necessary Special Qualifications: None. Examination Method: determined by the appointing authority.

Responsibilities

• Monitor daily system reports to ensure timely appeals processing.
• Participate in all scheduled unit meetings and with other Appeals staff.
• Analyze process improvements to ensure timely appeals and adherence to policies.
• Coordinate with Leads and Attorneys to monitor staff skills and progression.
• Create strategies to meet workloads and structure teams flexibly.
• Conduct regular team meetings, reviews, and trainings.
• Ensure timely time and leave records in Edison and internal systems.

Skills

Policy interpretation

Leadership

Team management

Communication

Education

Bachelor's degree

Five years professional experience interpreting policy

Job description

The State of Tennessee's TennCare division seeks an Appeals Litigation Specialist Manager in Nashville to oversee a team of Litigation Specialists and support Medicaid eligibility appeals proceedings. Under the Appeals Litigation Specialist Director, you will guide staff on policy interpretation, ensure timely appeals processing, and collaborate with attorneys and internal units to improve outcomes.

This role requires strong leadership and excellent writing and communication skills in a hybrid