Medicaid Policy & Projects Lead

South Dakota State Government; Pierre (SD); On-site; USD 68,000 - 74,000; Full time

Benefits offered by this job

Health insurance

Holidays

Leave accrual

Retirement benefits

Job summary

South Dakota Department of Social Services, Division of Medical Services, is seeking two policy, projects, and reimbursement specialists in Pierre. You will lead strategic initiatives, manage grants, and refine reimbursement methods while coordinating with internal divisions and stakeholders.

The role emphasizes policy development and data-informed decision making. The ideal candidate brings project management skills, Medicaid knowledge, and strong communication abilities.

Qualifications

• Experience with grant management, fiscal analysis, contract management, and healthcare reimbursement methodologies.
• Knowledge of medical coding and Home and Community Based Services waivers preferred.

Responsibilities

• Lead policy and strategic project initiatives including federal grants management.
• Manage policy projects and timelines ensuring quality and regulatory standards.
• Evaluate Medicaid programs for effectiveness and improvement opportunities.
• Lead efforts to update provider reimbursement methodologies.
• Manage contracts and draft RFPs; support policy implementation through training and communications.
• Coordinate with internal/external partners to align policy; monitor CMS guidance and trends.
• Develop and maintain Medicaid policies, procedures, and provider manuals.
• Use data to monitor performance and inform decisions; prepare briefs and recommendations.
• Prepare leadership correspondence and presentations; oversee Home and Community Based waiver oversight.

Skills

Project management

Leadership

Stakeholder coordination

Communication

Data analysis

Data visualization

Education

Bachelor's or Master's degree

Tools

PowerBI

Job description

South Dakota Department of Social Services, Division of Medical Services, is seeking two policy, projects, and reimbursement specialists in Pierre. You will lead strategic initiatives, manage grants, and refine reimbursement methods while coordinating with internal divisions and stakeholders.

The role emphasizes policy development and data-informed decision making. The ideal candidate brings project management skills, Medicaid knowledge, and strong communication abilities.