TENNCARE ADMINISTRATIVE JUDGE - 69842

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.

Background Check: 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:

The Division of TennCare operates Tennessee's Medicaid program, which provides health care to approximately 1.3 million Tennesseans. TennCare is responsible for handling eligibility applications and appeals from adverse actions affecting eligibility. The Administrative Judge (AJ) will interact with represented and unrepresented individuals and is expected to appropriately handle conflict situations. The job requires making unsupervised decisions that affect other people, financial resources, and/or the image and reputation of the agency. AJs are expected to impartially preside over TennCare eligibility hearings in accordance with the Uniform Administrative Procedures Act (UAPA) and draft legally and factually sound Initial Orders, incorporating their findings of fact and legal conclusions. AJs must be punctual, have regular work attendance, and be able to meet strict deadlines.

AJs must demonstrate a working knowledge of the Uniform Administrative Procedures Act, the Rules of Civil Procedure, the Rules of Evidence, and the Code of Federal Regulations. AJs will determine the issue(s) to be presented for each hearing; rule on objections, motions, and the admissibility of evidence; issue subpoenas; and administer oaths in preparation for hearings. When necessary, AJs will examine witnesses when necessary to gain all requisite facts. AJs will research and analyze applicable regulations, statutes, laws, and policies to determine conclusions of law. They will make findings of fact, based upon the testimony and evidence proffered at the hearing, and set forth those facts clearly in an Initial Order. In addition, AJs will respond to motions and petitions within the specified time frame.

Key Responsibilities:

• The AJs will be sitting for long periods during the workday, reviewing and listening to evidence and verbally communicating for several hours a day, and, when necessary, driving long distances to different hearing locations some of which require overnight travel.
• In addition, AJs must have the ability to accurately read documents for long periods (i.e., evidence and legal research), frequently compose exact legal documents, and resolve complex issues.
• AJs must be able to operate office computer systems and the electronic telephonic dialing systems.

Minimum Qualifications:

1. J.D. from an accredited law school; A current, valid license to practice law in Tennessee;
2. A minimum of 2 years of relevant experience is preferred;
3. Prior administrative law or courtroom experience is strongly desired;
4. Familiarity with Medicaid or other government benefit programs highly desired. OR an equivalent combination of education and work experience may be considered.

Desirable Qualifications:

1. This position is all about procedure, due process, and impartiality.
2. The person filling this position must understand the importance of ensuring that TennCare applicants and members are treated fairly and that their appeals are handled within the appropriate timeframes.

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 person's 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.