TennCare Advocacy Specialist at Family & Children's Services – Nashville, Tennessee

Position title: TennCare Advocacy Specialist
TennCare Advocacy Specialists will assist TennCare applicants and members, or persons or agencies on behalf of TennCare applicants and members pertaining to TennCare eligibility and TennCare covered services via telephone, mail, fax, or secure e-mail. TennCare Advocacy Specialists will provide information and assistance including, but not limited to, application and renewal processes, eligibility categories and requirements, program policies and procedures, covered services, and appeal rights and procedures. This position is predominately phone-based, and the phone line is staffed Monday through Friday, 8:00-4:30. Some travel may be required for outreach, trainings, and meetings. Some required outreach events may occur in the evenings and weekends.

Duties and Responsibilities

• Answer and make outbound calls in a manner consistent with established key performance indicators, TennCare Advocacy Call Center policies and procedures required by the funder.
• Assess, identify, and evaluate needs of callers or those who attend events to determine potential eligibility for TennCare and assist those who are eligible, refer others as appropriate.
• Maintain documentation in a clear, precise, and timely manner.
• Acquire and maintain proficiency in knowledge of the TennCare program, including appropriate application of policy and procedure, and in their familiarity of all ancillary agencies involved with the TennCare program. This includes the TennCare mental health and substance abuse covered services and providers.
• Provide TennCare applicants and members with assistance in creating and maintaining an online account using TennCare Connect during advocacy, outreach, or other forms of services provided.
• Provide TennCare applicants and members with assistance in linking cases to TennCare Connect accounts, uploading documents, application follow-up, and other actions such as selecting the individual’s communication preferences whether by mail, text, email, or some combination thereof.
• Provide ongoing support and assistance with completing a new application for any member who may lose TennCare eligibility during the year due to failure to provide TennCare with a Renewal Packet or other information.
• Use TennCare Access Portal (TCAP) to assist members and applicants with initial enrollment, renewal, submitting verification documents, and other eligibility or coverage related needs.
• Utilize resources shared by TennCare including, but not limited to, customer service contacts for eligibility and TennCare contracted Managed Care Contractors (MCCs), for member or applicant issue resolution. Staff must use a specified TennCare contact provided by TennCare for additional assistance.
• Provide Renewal Outreach services to TennCare members, by phone, in person, or events, prior to the due date of their annual Renewal Packet, which includes but is not limited to helping TennCare members who receive a Renewal Packet complete the packet and submit requested verifications through any available modality and inform the member of the requirements for returning requested verifications, as well as reporting changes in addresses and household circumstances.
• Handle sensitive and personal information with an understanding and respect for client and members’ confidentiality.
• Provide help and input, creating various materials for the TennCare Advocacy & Outreach program.
• Attend training that encompasses all facets of advocacy and outreach service delivery to TennCare applicants and members. Training topics shall include but not be limited to customer service, conflict resolution, de-escalation, interpersonal and problem-solving skills, and cultural and linguistic awareness of the LEP population and individuals with disabilities.
• Must attend all training provided or facilitated by TennCare for Policy, TennCare Access Portal, Medicaid Management Information System (MMIS), etc. within thirty (30) days of hire date.
• Must attend on-going in-service training and education in some or all the topics mentioned above on a semi-annual basis at minimum.
• Regular attendance during assigned office hours and reliable transportation required.

• Degree required and qualifications: This position requires a bachelor’s degree in sociology related field from an accredited college or university or one year experience working in the social services or mental health field. Demonstrated ability to work independently and in a team environment, and experience working with nonprofit organizations, community groups and/or government programs strongly preferred. Must know how to provide phone-based service, use computers, perform data entry, and use Microsoft Office.

Salary: $50,000
Submit resume to:
Email to hrdept@fcsnashville.org

EOE M/F/D/V