Enrollment functions: Reviews enrollment details and effective dates to ensure accuracy prior
to enrolling member. Works with team members to determine appropriate program enrollment.

Enters, deletes, and revises enrollment related actions in Interchange. Assists in the
redetermination process and submits lists of all members to be renewed to appropriate
external partners.

Disenrollment functions: Reviews and processes all requested and approved disenrollments, whether voluntary or involuntary, for TennCare LTSS members in an accurate and timely manner. Ensure effective dates are accurate and research discrepancies related to effective dates, preventing eligibility issues for members, providers, and MCOs. Communicate
disenrollment's for the Katie Beckett program to program leadership.

Transcribe approved PASRR determinations from the TMED system into the PERLSS system to allow for additional enrollment and eligibility actions to be taken on completed records.

The LTSS Operations team is requesting a contractor to assist with Enrollment Specialist level work related to enrolling and disenrolling TennCare members. Due to the implementation of a new eligibility system, PERLSS, the enrollment team is in need of additional assistance to manage the workload. PERLSS implementation requirements have increased the workload of existing team members and additional support is needed to maintain daily functions of the enrollment team to ensure enrollments and disenrollment's are handled timely and accurately.

The contractor role will allow the enrollment team members to manage PERLSS
related work, including monitoring and reporting defects, process improvements, and required work related to additional PERLSS implementation phases.

Additionally, with the Public Health Emergency ending, redeterminations for Medicaid programs will be restarting at the end of March. This will result in an increase in work as this process has been on hold for three (3) years and the enrollment team will be monitoring and following up on lists shared with MCOs, Nursing Facilities, DIDD, and other state partners to assist members with going through the renewal process. The contractor will provide needed assistance for the full redetermination process, ensuring no members lose eligibility that are attempting to go through this process.

 

Minimum qualifications
Graduation from an accredited college or university with a bachelor’s degree or graduation from an accredited college or
university with an associate’s degree and two years of qualifying professional experience
Excellent verbal and written communications skills
Proven technical skills (e.g. Microsoft Word, Excel, Outlook, PowerPoint, SharePoint, etc.)
Excellent time management skills and ability to multi-task and prioritize work in order to meet specific timeframes and
deadlines with minimal supervision
Keen attention to detail and adherence to deadlines
Organization
Self-motivated and able to thrive in a fast-paced and results-driven environment
Critical thinking and problem-solving skills