Managed Care Specialist

Client: Tennessee TennCare
Location: Nashville, TN Hybrid
Contract: 1 year extendable
Schedule: Monday Friday, 8:00 AM 4:30 PM CST

Position Summary

Tennessee TennCare is seeking Managed Care Specialists to support eligibility determination, case management, and legal administrative activities. Responsibilities include conducting client interviews, reviewing documentation, managing case records, and supporting attorneys with research and case preparation.

Key Responsibilities

• Determine individual and family eligibility for TennCare programs.
• Conduct client interviews, gather information, and prepare case recommendations for attorneys.
• Manage case documentation, deadlines, and resolution.
• Conduct legal research, review legal documents, and assist with drafting.
• Retrieve and maintain information across multiple databases.
• Coordinate schedules, communicate with stakeholders, and support team activities.

Required Qualifications

• Associate or bachelor's degree.
• Proficiency in Microsoft Word, Excel, Outlook, PowerPoint, and SharePoint.
• Strong written and verbal communication skills.
• Excellent organization, time management, and attention to detail.
• Critical-thinking, problem-solving, and multitasking abilities.

Nice-to-Have Qualifications

Candidates who meet one or more of the following qualifications will receive preference:

• Paralegal studies background.
• Experience in a legal environment.
• Customer service or call center experience.

Work Requirements

• Must reside in Middle Tennessee and commute to Nashville as needed.
• Hybrid schedule varies by team.
• Up to six weeks of mandatory virtual or onsite training.
• No preplanned PTO permitted during training.