ASSISTANT DIRECTOR QUALITY AND INNOVATION POLICY & PLANNING

Assistant Director Quality And Innovation Policy And Planning

Division of TennCare

Long Term Services & Support (LTSS)

Nashville, TN

Minimum Salary $61,200.00/ Year

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 criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

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 work 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.

Long-Term Services and Supports (LTSS) is one of the largest units within TennCare with a team of highly capable staff who are committed to leading the ongoing development and operation of an innovative, sustainable, person driven LTSS system. This program allows older adults and people with disabilities and/or chronic conditions to have choice, control, and access to a full array of high-quality services and supports that assure optimal outcomes, including independence, health, and quality of life.

The Assistant Director of Quality and Innovation (QI) Policy and Planning will play a vital role in supporting the development, implementation, alignment, and evaluation of policies and program design for the Quality and Innovation unit, as well as the overall LTSS division. This position will be responsible for staying abreast of changes in healthcare policy and legislation at state and federal levels and assisting with research and analysis of existing policy and contract requirements, as well as audit and evaluation results, to support development of LTSS program recommendations and strategic plans.

Key Responsibilities:

• Support the Director of QI Policy and Planning in researching and interpreting existing state and federal LTSS policies, regulations, guidelines, and contractor risk agreements to ensure compliant program administration, as well as assessing and communicating potential impacts of new and/or proposed regulations and requirements.
• Develop and present informational materials based on findings.
• Collaborate with LTSS teams including Audits, Quality and Evaluation, and Programs to review contractor deliverables, findings, and outcomes and develop recommendations for program and process improvements and opportunities for alignment.
• Assist with drafting and amending operational protocols, policies, contracts, guidance documents, reports, presentations, and communication materials to convey program updates, performance, recommendations, and other relevant information to internal and external stakeholders.
• Collaborate with the QI team directors to develop, implement and update processes and systems aimed at ensuring delivery of high-quality, person-centered supports for individuals enrolled in TennCare LTSS programs, as well as strategies and methodologies for evaluating process and system compliance, effectiveness, and efficiency.
• Assist with source identification and collection of data to ensure compliance with agency, state, and federal reporting requirements and inform quality improvement initiatives.
• Facilitate communications with Managed Care Organizations (MCOs), and Department of Intellectual and Developmental Disabilities (DIDD), including Subject Matter Experts (SME) on community transitions. Provide outreach, support, and technical assistance to internal and external stakeholders including state agency partners, managed care contractors, vendors, providers, and other LTSS and/or TennCare units, as requested. Other special projects as assigned.

Minimum Qualifications:

• Bachelor's degree in a related field AND 3+ years in similar role or in health care management or services; experience interpreting policy or procedural provisions for a TennCare, Medicaid, or other related health insurance organization is preferred.
• Experience in analyzing data and using data to drive performance and expectations.
• Experience with program management and/or grant management.

OR

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

Desirable Qualifications:

• Experience with policy research and analysis related to Medicaid, healthcare, and/or public programs.
• Demonstrated skills in both verbal and written communication, including the ability to distill complex information into clear, concise information for diverse audiences.
• Demonstrated organizational skills, including ability to prioritize, multi-task, and manage workload to meet specific timeframes and deadlines with minimal supervision.

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.