Medicaid Quality Coordinator (OSUS)

State of South Carolina; Cayce (SC); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Long Term Disability

Life Insurance

State Retirement Plan

Paid holidays

Paid parental leave

Job summary

South Carolina Department of Behavioral Health and Developmental Disabilities is seeking a Medicaid Quality Coordinator for the Office of Substance Use Services. The role provides administrative coordination and QA oversight for addiction services and Medicaid billing compliance.

The position works with SCDHHS, local authorities, and MCOs to improve care quality and cost-effectiveness, including audits, training, and compliance activities. This is a full-time temporary grant position.

Qualifications

• Master’s degree in a related field and professional human services experience.
• Current clinical license such as LPC or LISW-CP or equivalent is required.
• Working knowledge of behavioral health services, Medicaid policies, and billing practices.

Responsibilities

• Coordinate quality assurance oversight for addiction services and Medicaid billing compliance.
• Audit clinical charts to ensure documentation reflects treatment and billing aligns with Medicaid standards.
• Coordinate internal and state training, technical assistance, and continuous quality improvement plans.
• Prepare annual reports reflecting activities and tasks.

Skills

Public speaking

Communication skills

PowerPoint

Excel

Education

Master’s degree in a human services field

Licensed professional license such as LPC or LISW-CP

Tools

EHR systems

Excel

PowerPoint

Job description

Are you passionate about making a real difference in people's lives? Join our team at the Department of Behavioral Health and Developmental Disabilities (BHDD), Office of Substance Use Services (OSUS) where we are dedicated to providing compassionate and accessible care to our community. We are seeking a Medicaid Quality Coordinator to contribute to our team. If you want to use your skills to build a healthier, more resilient community, we encourage you to apply.

Under general supervision, this position provides administrative coordination and quality assurance oversight for addiction services, working closely with the South Carolina Department of Health and Human Services (SCDHHS), county alcohol and drug abuse authorities (i.e., local service providers), and managed care organizations (MCOs) to enhance the coordination of rehabilitative services for substance use disorders (SUDs) supporting providers for improved quality of contracted Medicaid services and billing through clinical technical assistance and training. This position:

• Acts as a substance use services liaison to SCDHHS for Medicaid policy and compliance providing support regarding Medicaid services for substance use and behavioral health services and collaborating with county authorities to ensure quality of services, and compliance with policy.
• Conducts audits of clinical charts to ensure treatment quality is reflected in appropriate clinical documentation, and billing practices adhere Medicaid standards. Collect treatment program data about beneficiary needs, services, costs and outcomes for monitoring purposes and evidence of cost effectiveness.
• Coordinates internal, state-level, and local training, learning collaboratives, and conducts topical technical assistance to drive improvement of program and service quality. Supporting development and implementation of continuous quality improvement plans that include performance outcome measures.
• Advises on quality assurance and/or compliance matters represents and leads in clinical quality improvement activities for enhanced substance use service and program provision internally, and in coordination with contractors. Leads development of annual report reflecting activities and tasks.

*This is a full-time temporary grant position*

The South Carolina Department of Behavioral Health and Developmental Disabilities, Office of Substance Use Services, offers an exceptional benefits package for this Temporary Grant position that includes:

• 15 days annual (vacation) leave accrual peryear
• 15 days sick leave per year
• 13 paid holidays
• Paid Parental Leave
• Health, Dental, Vision, Long Term Disability, and Life Insurance
• State Retirement Plan and Deferred Compensation Programs

A master’s degree from an accredited institution of higher education, professional experience in human services or social services programs, and current clinical license such as Licensed Professional Counselor (LPC), Licensed Independent Social Worker - Clinical Practice (LISW-CP), or similar licensure.

Working knowledge of the delivery of behavioral healthcare services. Working knowledge of billing practices and quality assurance standards for healthcare services, Medicaid and managed care policy. Familiarity with electronic health records, Strong word-processing skills and intermediate spreadsheet and PowerPoint skills. Competence in public speaking and exceptional communication skills.

About Our Agency:

The South Carolina Department of Behavioral Health and Developmental Disabilities, Office of Substance Use Services is South Carolina’s Single State Authority for Alcohol and Drug with a mission to ensure the availability and quality of a continuum of substance use service, thereby improving the health status, safety, and quality of life of individuals, families and communities across South Carolina. In the wake of the opioid epidemic, we are leading state agency in efforts to promote and establish evidence-based practices for prevention, treatment and recovery in our state.

EEO Statement:

The South Carolina Department of Behavioral Health and Developmental Disabilities provides affirmative action and equal opportunity in employment for all qualified persons regardless of race, color, sex--including the basis of pregnancy, childbirth, or related medical conditions, national origin, age, religion, or disability.

Supplemental Questions:

Supplemental questions are considered part of your official application. Any misrepresentation will result in your disqualification from employment. 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.