MANAGED CARE TECHNICIAN - 10132026-81723

Tennessee Department of Health; Nashville (TN); Hybride; USD 31 000 - 47 000; Plein temps

Avantages offerts par ce poste

Hybrid work schedule

Résumé du poste

Tennessee Department of Health in Nashville is seeking a detail-oriented clerical/customer service professional to support TennCare program tasks. The role involves data entry, processing paperwork, and coordinating with internal/external partners to ensure accuracy and compliance.

The position offers a hybrid work arrangement with in-office and remote work components, and requires high school level education with two years of clerical/customer service experience, including TennCare exposure.

Qualifications

• Education equivalent to graduation from a standard high school and experience equivalent to two years of clerical and/or customer service experience, one year in TennCare/Medicaid/Managed Care.

Responsabilités

• Communicating with people outside the organization to represent the organization to customers and the public.
• Interprets program rules and policies to facilitate understanding for internal and external partners.
• Provides guidance and direction to team members and monitors performance for timely completion of tasks.
• Performs day-to-day administrative tasks such as maintaining information files and processing paperwork.
• Evaluates data input and reports for completeness and accuracy and makes corrections as needed.

Connaissances

Clerical experience

Customer service experience

Data entry

Formation

High school diploma or equivalent

Two years clerical/customer service experience (one year in TennCare/Medicaid/Managed Care)

Outils

Office software

Description du poste

State of Tennessee Job Information

Opening Date/Time 10/13/2026 12:00AM Central Time

Job Information

State of Tennessee Job Information

Opening Date/Time 10/13/2026 12:00AM Central Time

Closing Date/Time 10/19/2026 11:59PM Central Time

Salary (Monthly) $2,607.00 - $3,908.00

Salary (Annually) $31,284.00 - $46,896.00

Job Type Full-Time

City, State Location Nashville, TN

Department Health

LOCATION OF (1) POSITION(S) TO BE FILLED: DEPARTMENT OF HEALTH, DAVIDSON COUNTY

This position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

This position is designed as Hybrid (In office and Remote).

Qualifications

Education and Experience: Education equivalent to graduation from a standard high school and experience equivalent to two years of clerical and/or customer service experience, of which one year must be in a TennCare, Medicaid, Managed Care, or any other related health insurance organization.

Substitution of Experience for Education: Qualifying experience in clerical and/or customer service work may substitute for the required education (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 One year of full-time work as a Managed Care Operator with the State of Tennessee.

Overview

An employee in this class assists professional Managed Care specialists in performing a variety of TennCare program assignments. Work involves assisting in such duties as conducting TennCare related research, processing claims, developing TennCare reports and program material, performing TennCare program planning and evaluation, and functioning as a lead worker to the Managed Care Operators. This class differs from that of classes in the Managed Care Specialist sub-series in that incumbents of the latter perform professional level TennCare program duties at a greater level of complexity and with more independence, and may supervise and/or provide technical guidance to incumbents in this class.

Responsibilities

• Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail.
• Interprets a variety of program rules, regulations, policies, procedures, and documentation for internal and external business partners to facilitate understanding, enhance communications, and ensure compliance .
• Provides guidance and direction to team members and monitoring performance to ensure timely completion of tasks.
• Analyzes internal and external information and evaluates results to choose the best solution and solve problems.
• Develops process improvement suggestions to streamline workflow and improve process cycle times and accuracy.
• Identifies the educational needs of others, developing formal educational or training programs or classes, and teaching or instructing others.
• Performs day-to-day administrative tasks such as maintaining information files and processing paperwork.
• Coordinates workload with internal and external partners as required to facilitate timely and accurate task completion.
• Evaluates data input for completeness, accuracy, and compliance with policies and standards, and makes changes as needed.
• Evaluates internally and externally generated reports for completeness and accuracy, and makes corrections as needed.
• Evaluates performance documents of agency employees submitted to supervisory personnel for compliance with performance evaluation guidelines.
• Identifies the developmental needs of others and coaches, mentors, or otherwise helps others to improve their knowledge and skills.
• Audits data input and performance of coworkers to ensure accuracy and departmental goals are met.
• Monitors information provided on documents received to ensure accuracy.
• Writes instructions for the assembly of an electronic or mechanic device to ensure functionality of the unit.
• Handles complaints, settles disputes, and resolves grievances and conflicts, or otherwise negotiates with others.
• Provides customer service to internal and external customers to maintain positive relationships and ensure positive results.
• Evaluates how well a subordinate or peer performs according to policies and program guidelines, as required, and consults with supervisors to assist in the performance evaluation process.
• Responds to complaints or needs from supervisors, coworkers, and/or subordinates regarding the function of equipment, materials, and surroundings in order to maintain a functional working environment, and contacts the proper entity for correction as needed.
• Documents auditing performed for employee performance purposes to ensure accurate information is used in decision making.
• Enters data into the appropriate computer program to enroll members and/or providers into services or reports services provided to members.
• Documents the performance of team members to ensure accurate and unbiased performance evaluations.
• Develops specific goals and plans to prioritize, organize, and accomplish work in an efficient manner.
• Provides guidance and expert advice to management or other groups on technical, systems, or process-related topics.
• Encourages and builds mutual trust, respect, and cooperation among team members.
• Analyzes internal and external data for planning work flow, and generates a report for supervisors to enable efficient completion of tasks.
• Analyzes internal and external paperwork for accuracy, and makes changes as needed.
• Analyzes data input to ensure accuracy, compliance with policies and standards, and for training and corrective actions.
• Sells program benefits and the services of the team to internal and external business contacts.
• Attends agency specific training as required to ensure compliance with departmental, state, and federal laws and guidelines.
• Uses office productivity software including but not limited to word processing programs, spreadsheet programs, presentation software, web-based email programs, and search engines to accomplish tasks.
• Receives applications through multiple media in order to enroll providers in the Medicaid Program.
• Receives data from TennCare on a weekly basis in order to generate the outreach call lists for completion and to ensure that eligible participants are aware of the services available to them.
• Receives information from superiors regarding policies, procedures, changes, and updates in order to provide the most current services to members and/or providers.
• Receives information from other departments, agencies, and constituents in order to enroll members into services.
• Consults with peers and subordinates regarding workflow in order to streamline the completion of tasks.
• Providing personal assistance, medical attention, emotional support, or other personal care to others such as coworkers, customers, or patients.
• Developing constructive and cooperative working relationships with others, and maintaining them over time.
• Identifies changes to policies to update standard operating procedures and ensure that the team's work is in compliance with the most current standards.
• Provides information to supervisors, coworkers, and team members by telephone, in written form, e-mail, or in person.
• Calculates and categorizes all applications received and calculates the number of providers and members enrolled on a daily basis, in order to provide a total weekly report to the manager.
• Tabulates specific upcoming and completed tasks to provide a report to supervisor and/or manager for quality assurance and planning.
• Repairs minor issues identified with general office equipment or reports the issue to the appropriate staff to ensure the functionality.

Competencies (KSA's)

• Intellectual Horsepower
• Learning on the Fly
• Problem Solving
• Informing
• Priority Setting
• Time Management
• Standing Alone
• Perseverance
• Comfort around Higher Management
• Written Communications
• Approachability
• Boss Relationships
• Composure
• Integrity and Trust
• Listening

Knowledge

• Clerical
• Customer and Personal Service
• Education and Training
• Law and Government

Skills

• Active Listening
• Critical Thinking
• Learning Strategies
• Reading Comprehension
• Speaking
• Writing
• Instructing
• Persuasion
• Complex Problem Solving
• Judgment/Decision Making
• Time Management

Abilities

• Deductive Reasoning
• Information Ordering
• Memorization
• Oral Comprehension
• Time Sharing
• Written Comprehension
• Dynamic Flexibility
• Hearing Sensitivity
• Speech Clarity
• Speech Recognition

Tools & Equipment

• Personal Computer
• Telephone
• Fax Machine
• Printer
• Copier/Scanner
• Other related office equipment as required

TN Driver Standards

State of Tennessee positions that may involve driving responsibilities require candidates to meet the following minimum driver qualifications:

• A valid driver's license
• For the past five years, the candidate's driver record must not have record of the following violations: driving under the influence (DUI), reckless driving, license suspension for moving violations, more than 4 moving violations.

Please include your Driver's License Information under the Licenses and Certifications section of your application.

• Agencies may allow an exception based on other factors.