IDD CLINICAL MANAGER- 56675

Executive Service

IDD CLINICAL MANAGER

Division of TennCare

Long Term Services & Support (LTSS)

Nashville, TN

Minimum Monthly Salary: $7,275/month

TennCare compensation is equitable and will be based on education and experience for a qualified candidate in accordance with Department of Human Resources (DOHR) policy.

Closing: 04/15/2024

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

The Division of TennCare is dedicated to providing our employees with a hybrid work environment. All TennCare positions have a combination of work from home and work in the office, which varies by position, department, and business need. You may review the specific expectations with our hiring team.

Who we are and what we do:

TennCare is Tennessee's managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities. TennCare provides coverage for approximately 1.7 million Tennesseans and operates with an annual budget of approximately $14 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).

TennCare's mission is to improve the lives of Tennesseans by providing high-quality cost-effective care. To fulfill that purpose, we equip each employee for active participation and empower teams to communicate and worked collaboratively to improve organizational processes in order to make a difference in the lives our members. Because of the positive impact TennCare has on the lives of the most vulnerable Tennesseans, TennCare employees report that their work provides them with a sense of meaning, purpose, and accomplishment. TennCare leadership understands that employees are our most valuable resource and ensures professional and leadership development are a priority for the agency.

Job Overview:

Under the supervision of the Assistant Deputy of Clinical Operations within the Long-Term Services and Supports (LTSS) Operations Unit, an employee in this position will serve as the Operations Clinical Director. Long-Term Services and Supports (LTSS) is one of the largest units within TennCare with teams of highly capable staff who are committed to leading the ongoing development and operation of an innovative, sustainable, person-driven long-term services and supports (LTSS) system in which older adults and people with disabilities and/or chronic conditions have choice, control and access to a full array of high quality services and supports that assure optimal outcomes, including independence, health and quality of life.

The successful candidate will be responsible for developing and overseeing policies related to medical eligibility for long term services programming as well as the staff making these eligibility decisions. The Candidate will oversee clinical decision making with a focus on behavior health and the IDD population and act as a resource for all clinically related work within the LTSS Operations unit regarding standards, policies, and procedures.

Key Responsibilities:

• Understand all medical eligibility criteria for LTSS programming and ensure that standards for implementation are clearly and accurately communicated to staff.
• Review and update policies, operating procedures, and manuals on an annual basis.
• Create new policies and procedures for any new programming.
• Assist in the review of all LTSS trainings related to medical edibility and coordinate with the Training Department to update or create trainings for both internal and external staff.
• Supervise and direct nursing staff making medical eligibility determinations.
• Assist in the collection and interpretation of data related to quality and coordination of LTSS operational functions.
• Provide guidance and oversight for complex transitions to and from LTSS programming.
• Monitor and provide oversight of processes involving aspects of behavior health programming for the IDD population.
• Serve as a backup to the Assistant Deputy of Clinical Operations as the need arises.

Minimum Qualifications:

Education and Experience:

Graduation from an accredited college or university with a bachelor's degree in nursing and experience equivalent to five years of full-time increasingly responsible professional nursing work, including at least one year of supervisory experience over professional nurses or one year of statewide oversight of a large program.

Substitution of Experience for Education:

Qualifying full-time experience in nursing may be substituted for the required education on a year-for-year basis, to a maximum of two years.

Substitution of Graduate Education for Experience:

Additional graduate coursework in nursing may be substituted for the required non-specialized experience on a year-for-year basis.

Necessary Special Qualifications:

Licensed as a Registered Nurse in the State of Tennessee.

Examination Method:

Education and Experience, 100%, for Preferred Service positions. For Executive Service positions, Minimum Qualifications, Necessary Special Qualifications, and Examination Method are determined by the appointing authority.

Pursuant to the State of Tennessee's Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State's policy to provide an environment free of discrimination and harassment of an individual because of that person's race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran's status or any other category protected by state and/or federal civil rights laws.