Licensed Attorney

Job id : 65020

Department : TN TennCare

Position : Attorney

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

Duration : 8 Months

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.

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 TennCare's 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 :

Bachelor's 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