State of Tennessee · 6 hours ago
MANAGED CARE PROGRAM MGR 1 - 02032026- 74813
Davidson County, TN
Contract
Hybrid
Senior Level
$55K/yr - $82K/yr
5+ years expThe State of Tennessee is seeking a Managed Care Program Manager to oversee TennCare's managed care entities, ensuring contract compliance and operational efficiency. The role involves managing a section, developing job plans, and leading subordinates in conflict resolution and performance monitoring.
AgricultureChildrenEducationGovernmentHealth Care
No H1B
U.S. Citizen Only
Responsibilities
Works in partnership with TennCare's business areas and TennCare's MCOs to translate Medicaid program requirements into contract language and deliverables. Provides oversight and accountability of the MCOs in meeting TennCare's needs
Develops job plans for assigned subordinates to communicate responsibilities and expected outcomes of performance in their role, strategies and objectives for assigned program areas, and strategies for addressing staffing and headcount needs to ensure adequate coverage for assigned workload. Explains program specific procedures and regulations to persons in other departments or divisions, or outside organizations and representatives, as required
Leads assigned subordinates in conflict resolution; developing and maintaining constructive and cooperative working relationships with others; monitoring and reviewing information; identifying the educational needs of others; developing trainings; and scheduling events, programs, and activities, as well as the work of others
Makes recommendations for changes in operations, efficiency and quality of agency operations and services. Analyzes production results over time to identify trends for staffing purposes and to ensure that enrollees receive the best possible services
Monitors and controls resources and oversees spending. Monitors the healthcare providers in each MCO's network to ensure that each MCO has enough providers in its network to provide timely access to care for all members
Recruits, interviews, selects, hires, and promotes employees in an organization. Schedules personal workload and the workloads of assigned subordinates
Resolves disciplinary actions and interpersonal conflicts between assigned subordinates to ensure a respectful and productive work environment. Completes performance evaluation documentation for all assigned subordinates
Contacts vendors and other outside agencies to obtain/provide required information, correct errors, and/or for clarification purposes. Communicates with outside callers to obtain/provide required information, correct errors, and/or for clarification purposes
Qualification
Required
Graduation from an accredited college or university with a bachelor's degree
Experience equivalent to five years of professional level experience interpreting policy or procedural provisions for a TennCare, Medicaid, Managed Care, or other related health insurance organization
One year of experience must include drafting contractual requirements, developing rules and regulations, or supervising professional staff who deal with health insurance
Qualifying professional experience interpreting policy or procedural provisions for a related health insurance organization may substitute for the required education to a maximum of four years
Four years of full-time work as a Managed Care Specialist, Managed Care Program Mgr, and/or Managed Care Division Director with the State of Tennessee
One year must be at the Managed Care Specialist 3 or higher level
Company
State of Tennessee
State government is the largest employer in Tennessee, with approximately 43,500 employees in the three branches of government.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Hugh Hale
Chief Information Officer, TennCare
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