REGULAR AND SPECIAL PROGRAMS ADMINISTRATOR - 56798

Executive Service

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:

The Division of TennCare is seeking a Regular and Special Programs Administrator in the Eligibility Operation Group within Member Services. This position is a direct report to the TennCare Member Services Deputy Director. This position will be indirectly supervising up to 100 staff and directly supervising up to 5 staff. The composition of these staff collectively includes, Directors, Program Managers, Program Coordinators, EAA 2's, Managed Care Specialist 3's, temporary resources, and other worker level staff. The Administrator will oversee the administration of the regular and special programs renewal and new application process including case maintenance to result in flawless application of TennCare programs policy and procedures while using data collected to improve front end eligibility determination. Using all resources available, the Administrator will make sound decisions and execute actions necessary to fulfill objectives that support TennCare' s mission and vision. Lastly, this position will develop effective relationships and strong communication across all units within Member Services, the Office of General Counsel, and all external stakeholders. Doing so will ensure collaboration and mutual understanding of matters affecting service delivery and policy implementation.

Key Responsibilities:

• Oversee 4 to 6 Units within Eligibility Operations Group and indirectly supervise up to 100 staff, composed of Directors, Program Managers, Program Coordinators, EAA 2's, Managed Care Specialist 3's, temporary resources, and other worker level staff.
• Oversee the completion of new applications and renewals related to escalations and process improvement for the Eligibility Operations Group.
• Oversee the process and procedures to determine quality and production across EOG.
• Oversee the ongoing unit specific training efforts and manage the performance process including goal evaluation and document review for initial, interim, and annual reviews.
• Develop a team of staff to comprise a Rapid Response Team to address escalated concerns from internal and external stakeholders that have critical needs.
• Direct and drive communication to and from internal and external stakeholders regarding the day to day operations of EOG units keeping the focus on the member.
• Focus on escalations received, and responses from executive team members and their direct reports.
• Exceptional proficiency in navigating, processing applications and case changes, and troubleshooting within TennCare' s Tennessee Eligibility Determination System (TEDS)
• Identify issues impacting eligibility determinations and propose remedial measures
• Oversee and engage in developing unit goals, priorities, objectives, and strategies for staff
• Ensure timeliness standards are met or exceeded by monitoring, assessing and addressing the team's overall performance
• Conduct regularly scheduled staff meetings to provide timely feedback regarding processes, initiatives, directives, and training opportunities
• Utilize established reports, and work toward development of new reports, to identify trends, errors, areas requiring improvement as well as celebrate team successes
• Provide clear and concise verbal and written communication and guidance to staff in a positive manner
• Effectively communicate with internal and external customers, colleagues, TennCare members and applicants
• Conduct regular coaching and guidance to ensure staff are meeting goals set forth by the agency and in compliance with TennCare policy and following established business processes
• Identify areas of opportunity and provide effective problem-solving techniques to ensure that areas of opportunity are resolved in a positive manner
• Build team morale to ensure a positive and inclusive work environment; leading to higher job satisfaction, and greater team efficiencies and effectiveness
• Minimum Qualifications:

Education and Experience:

Graduation from an accredited college or university with a bachelor's degree in a related field and four (4) years of management/supervision experience in either state government, healthcare or eligibility related field. Demonstrated team lead experience may substitute management/supervision experience.

OR

Graduation from an accredited college or university with an associate's degree in a related field and two (2) years of qualifying professional experience in a related field and four (4) years of management/supervision experience in either state government, healthcare or eligibility related field. Demonstrated team lead experience may substitute management/supervision experience.

Substitution of experience for education:

Experience equivalent to six (6) or more years of qualifying professional experience in a related field and four (4) years of management/supervision experience in either state government, healthcare or eligibility related field. Demonstrated team lead experience may substitute management/supervision experience.

• Proven capability and confidence in dealing with all levels in an organization and able to present a strong and clear rationale for proposed solutions, including when solutions may not align with business needs
• Ability to take initiative with tasks, be flexible, and accountable
• Ability to foster and maintain cohesive working relationships
• Ability to coach and mentor a diverse workforce
• Ability to learn quickly and exercise sound judgement
• Exceptional organizational skills, with proven ability to multi-task, adapt to changing priorities and deadlines, while applying creativity to solving complex problems
• Ability to prioritize and manage workload to meet specific time frames and deadlines
• Ability to interpret and execute public policy
• Expert research skills, including the ability to locate and analyze documents and integrate information from multiple sources
• Outstanding customer service skills, including the ability to problem solve, handle difficult situations, and escalate issues when necessary
• Excellent work ethic with an ability to receive and implement constructive feedback

Desirable Qualifications:

A master's degree in one of the following: public health, business administration or public policy

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 States policy to provide an environment free of discrimination and harassment of an individual because of that persons race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veterans status or any other category protected by state and/or federal civil rights laws.