ENROLLMENT SPECIALIST - Nashville, TN/On-Site
STI, Nashville, TN, United States
Overview
OPS ENROLL SPEC for E.B. This is an onsite position in middle Tennessee with regular commute to Nashville, TN. The standard work week is 37.5 hours per week. This role is a 1 year contract. Job Title: OPS ENROLL SPECIALIST/Administrative Services Assistant Location: Nashville, TN / On-Site Enrollment Responsibilities
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 disenrollments 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 needs additional assistance to manage the workload and maintain daily functions of the enrollment team to ensure enrollments and disenrollments are handled timely and accurately. The contractor role will support monitoring and reporting defects, process improvements, and required work related to additional PERLSS implementation phases. With the Public Health Emergency ending, redeterminations for Medicaid programs will restart at the end of March, increasing workload. The contractor will assist with the full redetermination process, ensuring no members lose eligibility during renewal processes and will coordinate with MCOs, Nursing Facilities, DIDD, and other state partners. Action Plan Timeline
Month 1: Training on new role, including shadowing and completion of new hire onboarding process. Month 2: Begin independent work with supervision; tasks include enrollment/disenrollment, transcribing PASRR determinations into TMED, and assisting with redetermination processes. Weekly check-ins with supervisor. Months 4-10: Fully independent in the role; provide required reports to supervisor. In months 9-10, discuss transition of tasks related to the eligibility system implementation. Months 11-12: Transition responsibilities to team members and finalize outstanding tasks. Create a transition plan to minimize gaps and ensure compliance with rules and timeframes. Minimum Qualifications
Graduation from an accredited college or university with a bachelor’s degree, or an associate’s degree with two years of qualifying professional experience Excellent verbal and written communications skills Proven technical skills (e.g., Microsoft Word, Excel, Outlook, PowerPoint, SharePoint) Excellent time management skills and ability to multi-task and prioritize work to meet 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
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OPS ENROLL SPEC for E.B. This is an onsite position in middle Tennessee with regular commute to Nashville, TN. The standard work week is 37.5 hours per week. This role is a 1 year contract. Job Title: OPS ENROLL SPECIALIST/Administrative Services Assistant Location: Nashville, TN / On-Site Enrollment Responsibilities
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 disenrollments 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 needs additional assistance to manage the workload and maintain daily functions of the enrollment team to ensure enrollments and disenrollments are handled timely and accurately. The contractor role will support monitoring and reporting defects, process improvements, and required work related to additional PERLSS implementation phases. With the Public Health Emergency ending, redeterminations for Medicaid programs will restart at the end of March, increasing workload. The contractor will assist with the full redetermination process, ensuring no members lose eligibility during renewal processes and will coordinate with MCOs, Nursing Facilities, DIDD, and other state partners. Action Plan Timeline
Month 1: Training on new role, including shadowing and completion of new hire onboarding process. Month 2: Begin independent work with supervision; tasks include enrollment/disenrollment, transcribing PASRR determinations into TMED, and assisting with redetermination processes. Weekly check-ins with supervisor. Months 4-10: Fully independent in the role; provide required reports to supervisor. In months 9-10, discuss transition of tasks related to the eligibility system implementation. Months 11-12: Transition responsibilities to team members and finalize outstanding tasks. Create a transition plan to minimize gaps and ensure compliance with rules and timeframes. Minimum Qualifications
Graduation from an accredited college or university with a bachelor’s degree, or an associate’s degree with two years of qualifying professional experience Excellent verbal and written communications skills Proven technical skills (e.g., Microsoft Word, Excel, Outlook, PowerPoint, SharePoint) Excellent time management skills and ability to multi-task and prioritize work to meet 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
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