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Managed Care Specialist 1-082918-170234

Expired Job

State Of Tennessee Nashville , TN 37201

Posted 5 months ago

Minimum Qualifications Benefits Supplemental Questions

LOCATION OF (16) POSITIONS TO BE FILLED: DIVISION OF TENNCARE, DAVIDSON COUNTY

Education and Experience: Graduation from an accredited college or university with an associate's degree.

Substitution of Experience for Education: Qualifying professional experience related to policy or procedural provisions associated with TennCare, Medicaid, CHIP, or other insurance and managed care related services within a hospital, healthcare, insurance and/or managed care organization. This experience could be obtained from work implementing policy in a like setting within state or local level governmental agencies or non-profit organizations for the required education to a maximum of two years (e.g., experience equivalent to one year of full-time work in one or a combination of the above listed fields may substitute for one year of the required education).

Substitution of Experience for Education: Two years of full-time work as a Managed Care Technician with the State of Tennessee.

Other Requirements:

Necessary Special Qualifications:
A valid motor vehicle operator license may be required.

Examination Method: Education and Experience,100%, for Preferred Service positions.

Job Overview:

Summary:
Under immediate supervision, is responsible for professional TennCare program work of routine difficulty; and performs related work as required.

Distinguishing Features: This is the entry-working class in the Managed Care Specialist sub-series. An employee in the class performs a variety of TennCare program work including resolving TennCare eligibility appeals, assisting long-term care facilities with claims processing issues, and assisting "walk in" TennCare members or applicants with TennCare claims or eligibility problems. This class differs from that of Managed Care Specialist 2 in that an incumbent of the latter performs TennCare program work of average difficulty with wider scope and complexity.

Competencies (KSA's):

Competencies:

  • Decision Quality

  • Learning on the Fly

  • Priority Setting

  • Time Management

  • Conflict Management

  • Standing Alone

  • Action Oriented

  • Organizational Agility

  • Approachability

  • Self Development

Knowledge:

  • Administration and Management

  • Clerical

  • Customer and Personal Service

  • Education and Training

Skills:

  • Active Learning

  • Active Listening

  • Critical Thinking

  • Learning Strategies

  • Monitoring

  • Reading Comprehension

  • Speaking

  • Writing

  • Instructing

  • Service Orientation

  • Time Management

Abilities:

  • Deductive Reasoning

  • Memorization

  • Oral Comprehension

  • Oral Expression

  • Time Sharing

  • Written Comprehension

  • Speech Clarity

  • Speech Recognition

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Managed Care Specialist 1-082918-170234

Expired Job

State Of Tennessee