Executive Service

The Division of TennCare is dedicated to providing our employees with a hybrid work environment. All TennCare positions have a combination of work from home and work in the office, which varies by position, department, and business need. You may review the specific expectations with our hiring team.

This position requires a background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

Who we are and what we do:

TennCare is Tennessee's managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities. TennCare provides coverage for approximately 1.7 million Tennesseans and operates with an annual budget of approximately $14 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS). TennCare's mission is to improve the lives of Tennesseans by providing high-quality cost-effective care. To fulfill that purpose, we equip each employee for active participation and empower teams to communicate and worked collaboratively to improve organizational processes in order to make a difference in the lives our members. Because of the positive impact TennCare has on the lives of the most vulnerable Tennesseans, TennCare employees report that their work provides them with a sense of meaning, purpose, and accomplishment. TennCare leadership understands that employees are our most valuable resource and ensures professional and leadership development are a priority for the agency.

Job Overview:

Operationally, the Quality Improvement (QI) Division works closely with several other TennCare divisions to lead the development and execution of a comprehensive quality strategy. Additionally, the QI team plays a strategic role in TennCare initiatives focused on improving clinical care and outcomes for TennCare members, including primary care transformation and population health. The QI Data Analytics team collaborates with other teams within the Chief Medical Office (CMO), including Dental, Pharmacy, Behavioral Health, and Appeals teams to provide analytics and dashboarding expertise. Externally, the QI division works closely with TennCare's contracted organizations and other state agencies to provide oversight of quality performance and data reporting for TennCare Members. This position will be a key member on the QI Data Analytics team reporting to the QI Data Analytics Deputy Director.

Key Responsibilities:

• Utilize data and analytic tools to meet quality reporting requirements and provide insights for clinical quality improvement.
• Query, collect, prepare, and safeguard data, and produce key deliverables to satisfy CMS, legislative, and other ad-hoc requests for data and information.
• Provide analytics expertise to review and summarize complex reports for the QI team and others.
• Evaluate quality measures at the individual provider or aggregate level using relevant information, individual judgement, and National Committee of Quality Assurance (NCQA) and CMS specifications.
• Utilize knowledge of claims data to identify key trends and data insights to inform CMO leadership decisions on key clinical areas and clinical outcomes.
• Participate in the design and development of a QI Dashboard highlighting projects and initiatives within the Quality Improvement department.
• Design and complete complex cost and outcome projections for various Quality Improvement programs.
• Perform quality checks of data and reports provided by Managed Care Organizations (MCO) and collaborate with the MCOs, as needed, for timely report completion.
• Partner with clinical data lead to support development of TennCare Quality Strategy: -Present relevant reporting information or quality data, both formally and informally, to small and large groups.
• Create presentation-ready deliverables for internal and external stakeholders.
• Manage special projects assigned by QI Division Director. Example projects could include HEIDS quality measure analysis, opioid usage analysis, maternal health analysis, and other disease specific analysis.
• Use TennCare data to explore and identify emerging areas that require clinical focus.
• Partner with other CMO teams to explore and utilize data specific to each team.
• Combine the TennCare claims data together with other data sources to provide insight, analytical consulting, and assess program performance and progress
• Train business users to understand and utilize final analytics deliverables.
• Work together to create Tableau dashboards to help visualize analysis critical to the team's scope of business.
• Assist with the creation of templates for various projects and with review of data from TennCare's MCO partners.

Minimum Qualifications:

A Masters Degree in statistics, applied statistics, social or behavioral sciences, health sciences, business, business administration, or public policy and 2+ years full time professional work developing research methodology and/or directing statistical research.

-OR-

A Bachelors Degree in statistics, applied statistics, social or behavioral sciences, health sciences, business, business administration, or public policy and 5+ years full time professional work developing research methodology and/or directing statistical research

-AND-

2+ years of statistical and analytical experience using SAS and/or SQL.

• Strong computer skills including mastery of Microsoft (Excel, Access, Word, and PowerPoint) as well as statistical software applications (SAS, R, Python, etc.)
• Strong, clear, and concise oral and written communication skills
• Strong organizational skills, including the ability to prioritize, multi-task, and manage workload to meet specific timeframes and deadlines.

2+ years of experience in Tableau or Power BI

• Experience in other visualization software
• Experience in healthcare field and/or with quality measurement
• Experience in survey development and analysis

Pursuant to the State of Tennessee's Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State's policy to provide an environment free of discrimination and harassment of an individual because of that persons race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran's status or any other category protected by state and/or federal civil rights laws.