Attorney

Position: Attorney

Department: TN TennCare

Location: 310 Great Circle Rd. Nashville Tennessee 37243 (Hybrid)

Duration: 12 Months

Shift- 8:00 AM to 04:30 PM

Job description:

• APPLICANTS/RESOURCES may also be expected to help with workload in either Litigation or Legal Review (whichever area they are not currently in) based on volume and work demands.
• To support an influx of eligibility appeals the (Legal Review Attorney) unit is requesting additional support in the attorney capacity to ensure federal timeline requirements can continue to be met with high quality.
• During an active assignment with the Division of TennCare the selected attorney contractors may be prohibited from the practice of law outside of their TennCare assignment. This is due to potential conflicts of interest etc. Please inform all candidates submitted.
• This position is Hybrid - the number of office days / remote days will be determined by the TennCare unit.

Description of Duties -

• Research and review appeals in TennCares Tennessee Eligibility Determination System (TEDS) database and make a valid factual dispute determination. 25% of total work effort
• Acquire and maintain a thorough understanding of Medicaid statutes regulations and policies. 25% of total work effort
• Review and monitor cases and appeals to ensure they are processed in compliance with Medicaid statutes regulations and policies. 25% of total work effort
• Identify issues affecting eligibility determinations and appeals and propose remedial measures. 25% of total work effort

Minimum Qualifications:

• Bachelors Degree from an accredited college or university
• Juris Doctor from an accredited college or university
• Active License to practice law in Tennessee
• Ability to foster and maintain cohesive working relationships
• Ability to adapt to changing priorities and deadlines
• Ability to exercise sound judgment
• Excellent organizational skills necessary including the ability to prioritize multi-task and manage workload to meet specific timeframes and deadlines
• Excellent writing and communication skills required
• Ability to interpret and execute public policy
• Ability to interface with multiple computer systems and applications

Desirable Qualifications:

• Knowledge of and experience with eligibility appeals procedures a plus
• Previous legal review experience a plus