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.
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.
Description of Duties:
Research and review appeal in 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
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