MEMBER EXPERIENCE DIRECTOR - 62274

Executive Service

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.

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.

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.

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:

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 1.5 million Tennesseans and operates with an annual budget of approximately $18 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).

Key Responsibilities:

Manage the TennCare Beneficiary Advisory Council and Medicaid Advisory Council

• Design, develop, implement, and lead the Beneficiary Advisory Council and the Medicaid Advisory Council, ensuring active participation.
• Organize regular meetings, set agendas, and facilitate discussions to gather feedback and insights from council members.
• Ensure council activities align with TennCare's strategic goals, objectives and initiatives.
• Compile and write reports of the councils' findings and recommendations.

Directly lead the TennCare member experience

• Develop a comprehensive member engagement strategy across TennCare that supports proactive communication and engagement with TennCare members.
• Develop and gather metrics for measuring member experience.
• Identify new, best practices and opportunities for continued advancement and evolution of a member-focused experience with TennCare.
• Analyze member engagement strengths and opportunities.

Integrate member engagement projects into new and existing programs, policies and operations

• Collaborate with various TennCare departments and TennCare health plans to understand and support new and existing initiatives.
• Collect and analyze feedback from advisory councils to gain insights into the experiences of TennCare members.
• Provide actionable recommendations to TennCare departments based on member insights to enhance program effectiveness and member satisfaction.
• Lead project management and develop reporting mechanisms to track successes, and opportunities for improvement related to member experience.

Minimum Qualifications:

Bachelor's degree from an accredited college or university in related field (master's degree in health care field preferred & MBA, MPH, MPP, or MHA) AND 3+ years in similar role or in health care management or operations. Experience interpreting policy or procedural provisions for a related health insurance or provider organization is preferred. Experience in analyzing data and using data to drive performance and expectations.

OR

an equivalent combination of education and work experience may be considered.

Desirable qualifications:

• Strong research, qualitative and quantitative skills, able to analyze data to draft proposals and presentations.
• Strong knowledge and understanding of Medicaid programs, policies, and regulations.
• Excellent communication skills, both written and verbal, including the ability to distill complex information into clear, concise information for diverse audiences.
• Competency in performance evaluation techniques and key metrics, data analysis, reporting and budgeting.
• Strong project management skills, ability to prioritize tasks, meet deadlines, and deliver high-quality results.
• Proven track record of successfully leading teams and driving organizational growth through effective planning and execution.
• Demonstrated ability to work collaboratively in a team environment and build relationships with internal and external stakeholders.
• Deep understanding of person-centered practices and individual outcome measures.
• Knowledge of value-based program strategies, cost of care initiatives, and performance analytics.
• Familiarity with program development and evaluation design
• Familiarity with data management and healthcare IT systems and electronic health records is advantageous.

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.