WAIVER PROGRAMS ELIGIBILITY SPECIALIST - 09292026- 81232

Opening: 09/29/2026 12:00AM CT – Closing: 10/12/2026 11:59PM CT. Location: Nashville, TN. Department: TennCare. Division of TennCare, Davidson County. This position requires a criminal background check. The Division offers a hybrid work environment.

About the role

Under general supervision, is responsible for highly technical professional TennCare program work of considerable difficulty and/or supervisory work of average difficulty; and performs related work as required. This is the highly technical professional or supervisory class in the Managed Care Specialist sub-series. An employee in this class performs highly technical TennCare program work or supervises a small to moderate sized unit of Managed Care Specialists and/or sub professional staff performing TennCare duties. This class differs from Managed Care Specialist 2 in that an incumbent of the latter performs TennCare program work of average difficulty and is not responsible for highly technical or supervisory work.

Responsibilities

• Leads peers/subordinates in compiling information for initial processes for program participation related to application, appeals, recertifications, etc.
• Leads in preparation of provider rates, the analysis of data from contractors, processes specific enrollment information, and verifies accuracy of information.
• Leads peers/subordinates in documentation and storing enrollee and/or provider information in electronic databases and/or physical form to track appeals, monitoring information, and ensuring accurate information.
• Completes the performance management process for direct reports and provides feedback related to assigned tasks.
• Conducts/leads training as required.
• Coordinates workload of peers/subordinates with internal/external business partners as required to facilitate task completion.
• Follows policies and procedures and identifies inconsistencies and errors to suggest corrective action to management.
• Provides regular updates to upper management and other partners on the status of assigned work or assigned projects.
• Provides consultation and advice relating to federal and state health policies to internal/external partners, applicants, and other stakeholders.
• Networks with internal/external business partners and maintains open dialogue.
• Leads peer/subordinates to liaise with other entities to ensure processing of requests.

Qualifications

Education and Experience: Graduation from an accredited college or university with a bachelor's degree or graduation from an accredited college or university with an associate's degree and two years of qualifying professional experience related to administrative, customer service and/or data entry positions associated with the application of policy or executing procedural provisions and/or eligibility within a health or healthcare, casework, or an insurance setting.

Substitution of Experience for Education: Qualifying professional experience related to administrative, customer service and/or data entry positions associated with the application of