PLAN REVIEWER - 04102026-76736

Job Information

LOCATION OF (1) POSITION(S) TO BE FILLED: DEPARTMENT OF DISABILITY AND AGING (DDA), WEST TENNESSEE REGIONAL OFFICE, SHELBY COUNTY

A Motor Vehicle Records screening will be conducted prior to employment.

This position is designed as Hybrid (In office and Remote).

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

Qualifications

Education and Experience: Graduation from an accredited college or university with a bachelor's degree in special education, education, rehabilitation or therapeutic health, nursing, sociology, social work, or any behavioral science field and experience equivalent to two years of working with persons with disabilities, aging, and/or mental health work.

Substitution of Education for Experience: Additional graduate coursework in special education, rehabilitation or therapeutic health, nursing, sociology, social work, or any behavioral science field may be substituted for the required experience on a year-for-year basis.

Substitution of Experience for Education: Qualifying professional intellectual and/or developmental disabilities, aging, or mental health work may substitute for the required education on a year-for-year basis.

OR

Education and Experience: Graduation from an accredited college or university with a bachelor's degree and experience equivalent to three years of working with persons with disabilities, aging, and/or mental health work.

OR

Education and Experience: Graduation from an accredited college or university with a bachelor's degree and completion of an internship with the Department of Disability and Aging.

Necessary Special Qualifications:

1. Complete a background check in a manner approved by the appointing authority.
2. Some positions may require a valid driver's license.
3. A Certified Work Incentives Coordinator (CWIC), Community Partner Work Incentives Counselor (CPWIC), or Certified Work Incentive Practitioner (WIP-C) Certification may be required for some positions.

Experience can substitute for degree.

Overview

The Plans Reviewer is responsible for ensuring timely, accurate and compliant processing of service request dispositions in accordance with current TennCare guidelines and Waiver rules. This role supports providers, support coordinators and case managers by delivering clear communication, maintaining accurate documentation, and upholding high standards of customer service. The ideal candidate is detail-oriented, collaborative, and experienced in supporting individuals with disabilities, ensuring the services are delivered in a person-centered manner.

Responsibilities

Issue service request dispositions to providers and support coordinators/case managers within required TennCare and Waiver time frames. Ensure all disposition deadlines are met. Complete data entry accurately and promptly. Communicate clearly and professionally. Provide strong customer service.

Competencies (KSA's)

1. Customer Focus
2. Action Oriented
3. Drives Vision and Purpose
4. Collaborates
5. Situational Adaptability

Tools & Equipment

1. Computer/Laptop/Tablet
2. Telephone
3. Printer
4. Automobile