TennCare Advocacy Specialist

Family & Children's Service; United States; On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical benefits

Dental and vision

401k with agency match

Paid vacation leave

Sick leave

12 weeks paid parental leave

11 agency holidays

More

Job summary

Family & Children\'s Service seeks TennCare Advocacy Specialists to assist applicants and members by phone, mail, or secure e-mail with eligibility and TennCare services. The role focuses on outreach, education, and help with TennCare Connect accounts.

The position requires a bachelor’s degree in sociology or related field or equivalent experience in social services, strong data-entry and Microsoft Office skills, and the ability to work independently within a nonprofit setting.

Qualifications

• Requires a bachelor’s degree in sociology or related field or one year in social services/mental health.
• Ability to provide phone-based service, use computers, data entry and MS Office.
• Demonstrated ability to work independently in a team environment and with nonprofit programs.

Responsibilities

• Answer and outbound calls per KPI and TennCare Center policies.
• Assess eligibility for TennCare and refer others as appropriate.
• Maintain documentation clearly and timely.
• Acquire proficiency in TennCare policies and related providers.
• Assist applicants with TennCare Connect accounts during advocacy and outreach.
• Link cases to TennCare Connect and manage communication preferences.
• Support renewal outreach and submission of verification documents.
• Use TCAP to assist with enrollment and verification needs.
• Utilize TennCare contacts for issue resolution.
• Attend training on policy, portal, MMIS and related topics; ongoing in-service training semi-annually.
• Ensure regular attendance and reliable transportation.

Skills

Phone-based service

Data entry

Bilingual (Spanish) preferred

Education

Bachelor's degree in sociology or related field

Tools

Microsoft Office

TennCare Connect

TCAP

Job description

TennCare Advocacy Specialists will assist TennCare applicants and members, or persons or agencies on behalf of TennCare applicants and members pertaining to TennCare eligibility and TennCare covered services via telephone, mail, fax, or secure e-mail. TennCare Advocacy Specialists will provide information and assistance including, but not limited to, application and renewal processes, eligibility categories and requirements, program policies and procedures, covered services, and appeal rights and procedures. This position is predominately phone-based, and the phone line is staffed Monday through Friday, 8:00-4:30. Some travel may be required for outreach, trainings, and meetings. Some required outreach events may occur in the evenings and weekends. Bilingual Spanish Preferred.

Job Responsibilities

Duties and Responsibilities

• Answer and make outbound calls in a manner consistent with established key performance indicators, TennCare Advocacy Call Center policies and procedures required by the funder.
• Assess, identify, and evaluate needs of callers or those who attend events to determine potential eligibility for TennCare and assist those who are eligible, refer others as appropriate.
• Maintain documentation in a clear, precise, and timely manner.
• Acquire and maintain proficiency in knowledge of the TennCare program, including appropriate application of policy and procedure, and in their familiarity of all ancillary agencies involved with the TennCare program. This includes the TennCare mental health and substance abuse covered services and providers.
• Provide TennCare applicants and members with assistance in creating and maintaining an online account using TennCare Connect during advocacy, outreach, or other forms of services provided.
• Provide TennCare applicants and members with assistance in linking cases to TennCare Connect accounts, uploading documents, application follow-up, and other actions such as selecting the individual’s communication preferences whether by mail, text, email, or some combination thereof.
• Provide ongoing support and assistance with completing a new application for any member who may lose TennCare eligibility during the year due to failure to provide TennCare with a Renewal Packet or other information.
• Use TennCare Access Portal (TCAP) to assist members and applicants with initial enrollment, renewal, submitting verification documents, and other eligibility or coverage related needs.
• Utilize resources shared by TennCare including, but not limited to, customer service contacts for eligibility and TennCare contracted Managed Care Contractors (MCCs), for member or applicant issue resolution. Staff must use a specified TennCare contact provided by TennCare for additional assistance.
• Provide Renewal Outreach services to TennCare members, by phone, in person or events, prior to the due date of their annual Renewal Packet, which includes but is not limited to helping TennCare members who receive a Renewal Packet complete the packet and submit requested verifications through any available modality and inform the member of the requirements for returning requested verifications, as well as reporting changes in addresses and household circumstances.
• Handle sensitive and personal information with an understanding and respect for client and members’ confidentiality.
• Provide help and input, creating various materials for the TennCare Advocacy & Outreach program.
• Attend training that encompasses all facets of advocacy and outreach service delivery to TennCare applicants and members. Training topics shall include but not be limited to customer service, conflict resolution, de-escalation, interpersonal and problem-solving skills, and cultural and linguistic awareness of the LEP population and individuals with disabilities.
• Must attend all training provided or facilitated by TennCare for Policy, TennCare Access Portal, Medicaid Management Information System (MMIS), etc. within thirty (30) days of hire date.
• Must attend on-going in-service training and education in some or all the topics mentioned above on a semi-annual basis at minimum.
• Regular attendance during assigned office hours and reliable transportation required.

Qualifications

This position requires a bachelor’s degree in sociology related field from an accredited college or university or one year experience working in the social services or mental health field. D e m o n s t r a t e d a b i l i t y t o w o r k i n d e p e n d e n t l y a n d i n a t e a m e n vir o n men t , and e x p e r i e n c e w o rk i n g w i t h n o n p r o f i t o r ga n i z a t i o n s, c o m m u n i t y gro u p s a nd / or gove rn me n t p r o gr a ms s t r o n gly p r e f e r r e d . Must know how to provide phone-based service, use computers, perform data entry, and use Microsoft Office.

Additional Information

F&CS has a robust benefits package

• medical
• dental and vision
• 401k with agency match
• paid vacation leave
• sick leave
• 12 weeks of paid parental leave
• 11 agency holidays in addition to the week between Christmas and New Year
• more

Details

• Date Posted: August 31, 2026
• Type: Full-Time
• Job Function: Programs and Service Delivery