Health Case Manager #1615 - CHANT - Health & Social Services Division

Health Case Manager #1615 - CHANT - Health & Social Services Division

Salary

$43,157.00 - $53,946.00 Annually

Location

HAMILTON COUNTY HEALTH & SOCIAL SERVICES, Chattanooga, TN

Job Type

FULL TIME

Job Number

08/03/2026 - 1615

Division

HEALTH & SOCIAL SERVICES DIVISION

Department

Chant

Opening Date

08/03/2026

Closing Date

8/16/2026 11:59 PM Eastern

• Description
• Benefits
• Questions

Description

The Hamilton County Health & Social Services Division has a responsibility to respond quickly and efficiently when public health emergencies occur. All Hamilton County Health & Social Services Division employees are responsible for ensuring their contact information is current and they are accessible should a public health emergency arise. The Hamilton County Health & Social Services Division maintains a call down system to store contact information and mobilize staff in the event of an emergency. During a public health emergency, all staff are required to respond should a call to mobilize be made. During a public health emergency, work hours for any and all Hamilton County Health & Social Services Division employees are subject to modification to meet the needs of the community.

Under general supervision, provides case management services to children and families at risk in the Health & Social Services Division; to assist referring clients to their primary care physicians or other identified professional; assists clients in negotiating the system in order to receive specialized care; to provide record and data, keeping; work with community resources.

ESSENTIAL FUNCTIONS: Essential functions, as defined under the Americans with Disabilities Act, may include the following tasks, physical requirements, knowledge, skills abilities, and other characteristics. This list of tasks is ILLUSTRATIVE ONLY, and is not a comprehensive listing of all functions and tasks performed by incumbents of this class.

Tasks

Provides Care Coordination for a caseload for medium to low risk families that have been referred to the CHANT program. Conducts a screening and assessment with individual/families utilizing the CHANT screening and Assessment Questionnaire. Will assist the family in navigation of care and goal setting per pathways of care. Identify appropriate referrals/resources based on the child/family needs. Conducts home visits as needed according to the program guidelines. Educates families using key educational messages. Will assist in planning and participating in targeted community-based outreach activities. Documents CHANT efforts completely using the Research Electronic Data Capture (REDCap) data capturing system. Will work as a team with CHANT staff.

Assists as a CHANT Health Case Manager working with the Nurse Specialist staff to submit client billing/invoices to the State Department of Health CHANT/Children & Youth with Special Healthcare NeedsCYSHCN program. Enters data into REDCap / Patient Tracking & Bill Management Information System (PTMBIS) Managed Care Organization (MCO) system; assists CYSHCN clients to obtain referrals for specialized medical services; presents medical necessity of each case to MCO; completes all forms based on doctors orders and assists clients with advocating for services with primary care physician (PCP). Seeks prior authorizations from MCO; documents all contact with or on behalf of clients/patients on CHANT/CYSHCN in REDCap system and into the PTBMIS (computerized state network) system. Assist CHANT staff with entering client encounters in the REDCap system and PTBMIS system on a regular basis per program guidelines. Mails welcome packet to families on the program including the CHANT/CYSHCN identification card. Follows up on weekly AP report received from Central off CHANT/CYSHCN staff. Follows up on referrals that have been requested but not received; contacts PCPs to remind of referrals, orders and authorizations necessary for services; tracks and follows up on CYSHCN appointments via telephone or by following up with Nurse Specialist or Central office; assists CHANT personnel in processing invoices, filing, monthly food request orders, and answering the telephone. Assists program receptionist/secretary in making telephone calls for CYSHCN personnel; updates and maintains current doctors' addresses and telephone information for accurate referrals; performs other related duties as assigned. Requests medical records and medical history diagnosis form to be completed. Keeps an ongoing active list of current CHANT/CYSHCN statewide vendors and assists with contacting vendors and mailing renewal packets per the TN Dept. of Health's request.

Works with Children's Special Services (CSS) Staff and the Nurse Specialist to submit client billing to the State Department of Health CSS Program; enters data into PTMBIS system; assists CSS clients to obtain referrals for specialized medical services; presents medical necessity of each case to Managed Care Organization (MCO); completes all forms based on doctor's orders; assists clients with advocating for services with primary care physician (PCP); seeks prior approval from MCO; documents all contact with or on behalf of clients/patients in CSS records and into the PTBMIS (computerized state network) system and coping referral for client's charts.

Follows up on referrals that have been requested but not received; contacts PCPs to remind of referrals necessary for services; assists CSS personnel in processing invoices, filing and answering telephone; assists receptionist in making telephone calls for CSS personnel; updates and maintains current doctor's addresses and telephone information for accurate referrals; performs other related duties as assigned. Follows up with the Newborn Screening for Genetic and Hearing loss to follow up and the School Based Dental referral list.

Knowledge, Skills, Abilities, and Other Characteristics

Knowledge of federal, state, and county laws, rules, regulations, policies and procedures related to health case management.

Knowledge of MCO, and other insurance providers, methods, policies and procedures.

Knowledge of case management practices and procedures.

Knowledge of customer service/public relations methods and practices.

Knowledge of specialized health care needs of assigned clients.

Knowledge of computer hardware, software and peripherals pertinent to assignment.

Knowledge of community resources related to area of assignment.

Skill accurately and timely completing referral forms for MCO and other insurance providers.

Skill accurately and timely entering and retrieving data from computerized systems.

Skill maintaining accurate updated files and records.

Skill working with doctors, clinics, and other health care providers in seeking referrals and services for clients.

Skill utilizing customer service/public relations techniques when responding to inquiries and complaints.

Skill establishing and maintaining effective working relationships.

Skill coordinating community resources based on client needs.

Skill effectively communicating in both oral and written form.

Minimum Qualifications

A Bachelor's degree in in Human Services, Social Sciences, Business, Communications or a related field.

OR

An Associate's degree in in Human Services, Social Sciences, Business, Communications or a related field and two (2) years of direct work experience in an insurance or managed health care setting working with Centers for Medicare & Medicaid Services and TennCare clients. A valid driver's license is required.

OR

The equivalent of a high school diploma and four (4) years of direct work experience in an insurance or managed health care setting working with Centers for Medicare & Medicaid Services and TennCare clients. A valid driver's license is required.

ADDITIONAL REQUIREMENTS:

Prior to operating a County-owned vehicle, all employees are required to complete the HC Defensive Driving course and/or an Emergency Vehicle Operations Course (EVOC) provided at the department level.

This position is deemed essential/situational during inclement weather situations and must report to or remain at work, even when administrative closings are announced, as determined by the Department Head.

PHYSICAL REQUIREMENTS:

Work involves extensive use of computer keyboarding and telephoning while convincing PCP and MCO providers to refer and see clients. Work requires working with high risk, confrontational, mentally and physically ill, and economically disadvantaged populations with exposure to infectious diseases. Some positions require outreach and home visitation. Work may involve working after regular business hours in high crime areas, or making home visits.

ADDITIONAL INFORMATION:

This job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Any overtime hours offered in this position are not guaranteed, are an estimate, and are subject to change.

All positions within Hamilton County Government are considered work in-person and require regular and punctual attendance.

All positions within Hamilton County Government may require work on Holidays or weekends. Additionally, irregular hours and shift work may be required, including possible extension of shift hours, at times with short notice.

AN EQUAL OPPORTUNITY EMPLOYER

Hamilton County does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. A copy of Hamilton Countys Equal Employment Opportunity Plan (EEOP) & Utilization Report is available on the County's Equal Employment Opportunity (EEO) Office home page.

https://www.hamiltontn.gov/Department_EqualEmploymentOpportunityOffice.aspx

Hamilton County Government

Meeting the needs of the people where they live, work, and play!

Hamilton County, Tennessee offers a lower cost of living, ease of getting around, a lively arts tradition, and abundant outdoor recreational opportunities.

Working for Hamilton County Government provides many great benefits - take a look at a few of those highlighted below…

On-Site Employee Health Clinic

• No copay to utilize clinic services.
• Clinic services include routine office visits, sick visits, labs, flu shots, and more
• TextCare - Access to care 24/7 via TextCare, which is direct, unlimited access to medical care 24/7 through text message.

(Employee access to the clinic is available from day one. A covered spouse or dependent has access as soon as their health plan coverage is effective. Children age 3 and up who are covered by the County's insurance are eligible to be seen.)

• Telehealth - Two-way, real-time interactive communication between the patient and a practitioner through telecommunications, which may include audiovisual options.
• One to One Provider Network - Availability to utilize a network of providers that provide a high level of care at a lower copay/cost.
• Health Management Programs - Offered to help employees and their family members in managing the following health conditions: Asthma, Diabetes, Hypertension (High Blood Pressure), and Hyperlipidemia (High Cholesterol)
• Nutritional guidance - Nutritional education provided to assist in making the appropriate food /health choices.

On-Site Employee Pharmacy

• Low-cost prescriptions available to those covered under the County health plan.
• Over the counter items offered at cost.
• RxLocal App - Mobile app provides a convenient way to stay connected and manage your health. Through the app you can request refills and ask questions.
• On-site Pharmacist available to answer questions and provide information.

Hamilton County Government offers competitive insurance coverage to fulltime employees.

Medical coverage is offered through Cigna to fulltime employees. The County pays a generous portion of the medical premium. Two options are available to choose from: LCP (Local Cost Plus) and OAP (Open Access Plus).

• The LCP has a smaller network that includes most providers and hospitals, with the exception of Parkridge facilities/providers.
• The OAP is a national network of facilities/providers that includes most providers/hospitals, including Parkridge.

Dental coverage is a voluntary benefit available to fulltime employees. Three coverage options are offered: Cigna High Plan, Cigna Low Plan, and Sun Life DHMO.

• The Cigna High Dental Plan covers orthodontia for children up to age 18. A national network of dental providers is available to choose from and this plan offers out of network coverage.
• The Cigna Low Dental Plan does not cover orthodontia. A national network of dental providers is available to choose from and this plan offers out of network coverage.
• The Sun Life DHMO plan is a prepaid dental plan that offers benefits through a network of plan dentists. A dental provider must be selected when enrolling and services must be provided by that provider for benefits to apply.

Life Insurance/Accidental Death and Dismemberment is provided through Symetra. The County provides $30,000 of Basic Life/Accidental Death and Dismemberment coverage at no cost to fulltime employees.

Additional voluntary benefits fulltime employees have access to enroll in are as follows:

• Individual Short-Term Disability (STD) -Voluntary Long-Term Disability (LTD)
• Flexible Spending Account-Health Care -Flexible Spending Account-Dept. Care
• Flexible Spending Account-Transportation -Accident Insurance
• Critical Illness Insurance -Hospital Indemnity Insurance

Hamilton County Government Retirement for Fulltime Employees:

Pension - Legacy Plan (hired prior to 10/1/2015), in which the employer contributes 14.70%.

Pension - Hybrid Plan (hired on or after 10/1/2015), in which the employee contributes 5% and the employer contributes 4%.

401K - Employer contributes 5% and the employee can contribute the amount of their choice.

457b - Employees have the option to contribute to this plan if they choose.

Pre-Retirement Seminar:

Hamilton County Human Resources provides a pre-retirement seminar to those considering retirement, two times per year (1st and 3rd quarter of each year). Seminar topics covered may include:

• Health insurance assistance, Medicare info and counseling.
• Internal steps to take when an employee is ready to retire.
• Estate Planning
• Personal Financial Planning
• TCRS (Tennessee Consolidated Revenue Service) - Ham. County Pension
• Deferred Compensation/457 Plan - Nationwide
• Social Security Benefits

Parental Leave:

Hamilton County provides eight (8) weeks of paid maternity leave and two (2) weeks of paid paternity leave following the birth of a child or placement of a child with an employee in connection with adoption (age 13 or younger) or foster care.

Paid Time Off:

Hamilton County Government provides generous paid time off (PTO) to fulltime employees from the start of employment.

• Years 1 - 5: an employee will accrue 5.85 hours of leave, per pay period.
• Years 5 - 10: an employee will accrue 6.77 hours of leave, per pay period.
• Years 11-15: an employee will accrue 8.31hours of leave, per pay period.
• Year 15 and each year thereafter, an employee will accrue 8.93 hours of leave, per pay period.

At each anniversary, an employee can roll over up to 80 hours of unused PTO into their leave bank. (Up to 800 hours for employees hired on or after 1/1/2013).

Paid Holidays:

Hamilton County Government provides thirteen (13) paid holidays to fulltime employees.

New Year's Day Independence Day

M.L. King's Birthday Labor Day

President's Day Veteran's Day

Good Friday Thanksgiving (2 days)

Memorial Day Christmas (2 days)

Juneteenth

Wellness Facility:

Hamilton County Government provides a 24/7 fitness center, free of charge, to County employees and family members (age 14+) covered under the Countys health plan. The fitness center offers cardio and strength-training equipment, along with group exercise classes throughout the year. (which may include Zumba, spin, yoga, etc.)

01

To meet the minimum qualifications for this position, applicants must meet all of the criteria listed in qualification A, qualification B, or qualification C. Qualification A - A Bachelor's degree in in Human Services, Social Sciences, Business, Communications or a related field. OR Qualification B - An Associate's degree in in Human Services, Social Sciences, Business, Communications or a related field and two (2) years of direct work experience in an insurance or managed health care setting working with Centers for Medicare & Medicaid Services and TennCare clients. A valid driver's license is required. OR Qualification C - The equivalent of a high school diploma and four (4) years of direct work experience in an insurance or managed health care setting working with Centers for Medicare & Medicaid Services and TennCare clients. A valid driver's license is required. Do you meet qualification A, qualification B, or qualification C?

• Yes, I meet qualification A.
• Yes, I meet qualification B.
• Yes, I meet qualification C.
• I meet some of qualification A.
• I meet some of qualification B.
• I meet some of qualification C.
• No, I do not meet qualification A, qualification B, or qualification C.

02

What is your highest level of education completed?

• I do not have a GED or High School Diploma.
• GED
• High School Diploma
• Associates Degree
• Bachelors Degree
• Masters Degree
• Doctoral Degree

03

If you indicated you possess a degree, please tell us the field of study your degree is in.

04

How many years of direct work experience do you have in an insurance or managed health care setting working with Centers for Medicare & Medicaid Services and TennCare clients?

• No experience
• Minimal, less than one year.
• 1-2 years
• 2-3 years
• 3-4 years
• 4-5 years
• 5-6 years
• 6-7 years
• 7-8 years
• 8-9 years
• 9-10 years
• 10 years or more

05

How would you describe your skill level using Microsoft Outlook?

• No experience - I am unfamiliar with Microsoft Outlook.
• Basic- I occasionally use Microsoft Outlook at my current (or at a previous) job.
• Average - I use Microsoft Outlook at least once a week at my current (or at a previous) job.
• Advanced - I use Microsoft Outlook daily at my current (or at a previous) job.

06

How would you describe your skill level using Microsoft Word?

• No experience - I am unfamiliar with Microsoft Word.
• Basic- I occasionally use Microsoft Word at my current (or at a previous) job.
• Average - I use Microsoft Word at least once a week at my current (or at a previous) job.
• Advanced - I use Microsoft Word daily at my current (or at a previous) job.

07

How would you describe your skill level using Microsoft Excel?

• No experience - I am unfamiliar with Microsoft Excel.
• Basic- I occasionally use Microsoft Excel at my current (or at a previous) job.
• Average - I use Microsoft Excel at least once a week at my current (or at a previous) job.
• Advanced - I use Microsoft Excel daily at my current (or at a previous) job.

08

Do you have direct work experience that required you to utilize customer service/public relations techniques when responding to inquiries and complaints?

• Yes
• No

09

Do you have direct work experience that required you to maintain accurate updated files and records?

• Yes
• No

10

Do you have direct work experience that required you to complete referral forms for MCO and other insurance providers?

• Yes
• No

11

Do you have direct work experience that required you to work with doctors, clinics, and other health care providers in seeking referrals and services for clients?

• Yes
• No

12

Are you fluent in both English and Spanish? This is not a requirement for the position.

• Yes
• No

13

Do you possess a valid drivers license?

• Yes
• No

14

Have you ever served in the United States Armed Forces?

• Yes
• No

15

The answers you provide in the "Supplemental Question" portion of the application will be used to review/process your application. Once this job posting closes, your answers to the supplemental questions cannot be changed. Have you reviewed your answers and verified they are correct?

• Yes
• No

Required Question

Employer Hamilton County

Address 401 W MLK Blvd

Chattanooga, Tennessee, 37402

Phone 423-209-6120

Website http://www.hamiltontn.gov