INTERNAL Program Coordinator II (Member Services Coordinator) / 60013321RP

South Carolina DDSN; South Carolina; On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Health, Dental, Vision Insurance

Vacation leave

Sick leave

13 holidays

State retirement plan

Job summary

South Carolina DDSN is seeking a Program Coordinator II (Member Services Coordinator) to support the Department of Member Services within the Bureau of Provider and Support Services. This in-office role manages inquiries, escalations, and policy knowledge for SC Medicaid members while collaborating with internal teams and providers.

The ideal candidate holds a bachelor’s degree and at least two years of SC Medicaid experience, with strong communication, organizational, and software skills.

Qualifications

• Bachelor's degree and at least two years of experience with SC Medicaid or related work.
• Ability to respond to inquiries via email and phone and document resolutions in Service Manager.
• Knowledge of MMIS, Curam and other agency software; stay updated on SC Medicaid policy.

Responsibilities

• Respond to applicants, members, legislative inquiries via email and telephone.
• Develop knowledge of SC Medicaid policy and MMIS, Curam, and other agency software.
• Serve as liaison with Medicaid provider organizations and advocacy groups.
• Identify trends and opportunities for process improvement.
• Participate in professional development and training.
• Attend and participate in project teams to support bureau priorities.

Skills

Verbal communication

Written communication

Organizational skills

Research skills

Education

Bachelor's degree

Tools

OnBase

MMIS

Curam

Microsoft Office

Job description

*This position is a re-post. Previous applicants do not need to re-apply.*

***Internal Posting- Only current SCDHHS Employees will be considered.***

The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.

This is position is located inBureau of Providers & Support Services, Richland County.
This is an in-office role and not a telecommute or remote position.

Are you the One? We are looking for a Program Coordinator II (Member Services Coordinator)who, under the supervision of the Member Services Program Manager I, and in collaboration with the Department of Member Services within the Bureau of Provider and Support Services, researches and provides resolution for legislative referrals, internal stakeholders, and other escalation points regarding affected SC Medicaid members. Ensures a positive member experience by following, assisting, and resolving elevated problems and concerns.

• Respond to applicants, members, legislative constituents, and authorized representative inquiries via email and telephone – based on SC Medicaid policy and procedures. Ensure all inquiries referred to Member Services are addressed accurately, appropriately, and timely. All inquiries/referrals, follow-ups, and resolutions must be documented in Service Manager 100% of the time.
• Develop and maintain knowledge of current SC Medicaid Policy and Procedures, Medicaid Management Information System (MMIS), Curam and other agency software to work efficiently in the position. Stay abreast of other human services resources to ensure appropriate assistance is provided to applicants and beneficiaries. Other resources include but are not limited to - Managed Care, Nursing Home/Community Long Term Care, Social Security, Office on Aging, Department of Social Services (DSS), WELVISTA, etc. Serve as liaison with Medicaid provider organizations, advocate groups, and other agencies who serve the Medicaid population. Participate in scheduled meetings and ongoing trainings to ensure changes and revisions within policy are retained. Stay abreast of SC Medicaid related issues within the Agency and external agencies.
• Develop and maintain knowledge of the various internal agency departments and their functions within the organization. Develop relationships with internal staff who may be beneficial in assisting with Member escalations (i.e., pharmacy, claims, managed care, eligibility, provider, etc.). Work as a team-player within Member Services, the Bureau of Provider and Support Services, and within the agency at-large.
• Identifies trends and process improvement opportunities as a part of the Members Services internal escalation team.
• Attend and participate in relevant opportunities for professional development and training. Demonstrate utilization and application of new skills learned to improve effectiveness and efficiency within assigned responsibilities.
• Participate as a project team member, as needed, or assigned, to support reference administration interests and bureau priorities aligned with strategic goals and agency mission and objectives. Other duties, as assigned, i.e., pilot projects, mentor to new hires, lead role for improvement efforts (not a formal project) and to assist other teams within and outside of our bureau. When requested, participate in events or projects that promote better efficiency, effectiveness and/or teamwork.
  
  
  

The South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes:

• Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
• 15 days annual (vacation) leave per year.
• 15 days sick leave per year.
• 13 paid holidays.
• State Retirement Plan and Deferred Compensation Programs.

A bachelor’s degree and at least two (2) years of experience with SC Medicaid, Eligibility, Support Services, SC Medicaid policy, or other related work experience.

Relevant experience may be used in lieu of a bachelor's degree on a year for year basis with Human Resources approval.

Additional Requirements:

• Valid driver's license.
• Occasional overnight travel.
• Requires holder to drive routinely.
• Overtime and/or weekend work with Deputy approval.
• Sitting or standing for long periods of time.
• Lifting requirement: 10 lbs.
• In-office role.

• Computer skills to include Word, Excel and Power Point.
• Knowledge of OnBase, Medicaid Management Information System (MMIS), Workload Pro, and Curam.
• Organizational skills and ability to work in a self-directed manner, using good judgement and own discretion.
• Excellent verbal and written communication skills.
• Actively support SCDHHS's mission and strategic plan, including an understanding of the critical nature of the agency's work to support and improve efficiencies regarding SC Medicaid members, providers, and other stakeholders.
• Ability to effectively receive, plan and complete time-bound requests that require research, collaborating with internal and external partners, periodically with tighter timelines than others.
• Ability to interpret member’s needs and document tasks completed and other requirements in Service Manager.
• Ability to analyze information, reduce to logical order, and implement a plan of action when assisting escalated issues for members and other stakeholders.
• Ability to communicate in a thorough, clear, and concise manner to improve efficiencies, and educate collaborators and members to achieve a common goal.
• Ability to provide training to groups and individuals regarding Medicaid eligibility, and other topics as needed.
• Proficient in Word, Excel, Power Point, and the ability to learn new software as required.

Please complete the State application to include all current and previous work history and education. A resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position. Supplemental questions are considered part of your official application for qualification purposes. All applicants must apply online. All correspondence from the Office of Human Resources will be through electronic mail.

The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions, including, but not limited, to lactation), national origin, age (40 or older), disability or genetic information.