Program Coordinator II (EEMS Respondent Supervisor (Non-MAGI & LTC) / 60013951RP

State of South Carolina; Columbia (SC); On-site; USD 42,000 - 60,000; Full time

Job summary

The State of South Carolina's Department of Health and Human Services is seeking a Program Coordinator II (EEMS Respondent Supervisor) to lead Non-MAGI and LTC Eligibility Respondent Coordinators. You will supervise case assignments, monitor progress, and attend hearings to support eligibility decisions.

Candidates should have a bachelor’s degree and relevant program experience, with knowledge of Medicaid policies. In-office role with occasional travel and driving requirements are possible.

Qualifications

• Bachelor’s degree and relevant program experience.
• Knowledge of Medicaid eligibility policies preferred.

Responsibilities

• Supervise Non-MAGI and LTC Eligibility Respondent Coordinators; assign cases and monitor progress.
• Attend hearings to represent the Department of Health and Human Services and present evidence.
• Ensure the final administrative decision issued by the Division of Appeals and Hearings is followed in all Non-MAGI and LTC eligibility appeal cases.
• Stay current on SCDHHS policy and procedures pertaining to Medicaid eligibility and appeals process.
• Perform supervisory and leadership duties in accordance with agency policies and procedures.
• Complete other duties as assigned.

Skills

Oral communication

Written communication

Attention to detail

Judgment and discretion

Policy interpretation

Team supervision

Education

Bachelor’s degree in relevant field

Job description

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

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 in Eligibility Appeals & Quality, 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 (EEMS Respondent Supervisor (Non-MAGI & LTC)) who will promote the mission and values of SCDHHS. Under limited supervision, serves as first-line supervisor for Non-MAGI and LTC Eligibility Respondent Coordinators. Will represent the agency in both formal and informal hearings and appeals processes. Reviews case summaries and appeal packets for Non-MAGI and LTC cases to ensure they are accurate and complete prior to sending to the Division of Appeals and Hearings and petitioner. May have to assist with writing appeal summaries. Assigns cases to team members as well as monitors team members' progress with cases. Tracks case status and reports case status to Manager.

• Serves in a supervisor role for the team. Assigns cases to team members, monitors and tracks case progression. Assists team members with policy clarification as needed. Reports case progression to Manager.
• Attends hearings to represent the Department of Health and Human Services and present evidence to support the eligibility decision.
• Ensure the final administrative decision issued by the Division of Appeals and Hearings is followed in all Non-MAGI and LTC eligibility appeal cases. Follow Medicaid policies and procedures to respond to the petitioner if an appeal is filed based on a new decision. Take necessary actions to determine/reinstate eligibility when the previous decision was reversed.
• Stays abreast of all current SCDHHS policy and procedures pertaining to Medicaid eligibility and appeals process.
• Performs fundamental supervisory and leadership functions in accordance with Department policies and procedures, best practices and Federal and State rules and regulations, especially with regard to Equal Employment Opportunity Commission (EEOC) standards. Maintains an effective Organizational team and motivates diverse staff to accomplish mission critical operations and objectives. Promotes workforce engagement.
• Complete other job duties as assigned. May require performing tasks across the team or other business units within the agency.

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 relevant program experience.

An equivalent combination of experience and education may be considered with prior State Human Resources approval.

PREFERRED: Knowledge of Medicaid (Non-MAGI and Long-Term Care (LTC) eligibility) and the SCDHHS appeal process.

Additional Requirements:

• Valid driver's license.
• Requires holder to drive routinely.
• Occasional overnight travel.
• Overtime and/or weekend work with Deputy approval.
• Sitting or standing for long periods of time.
• Lifting requirements: 20 lbs.
• In-office role.

• Knowledge of SCDHHS Medicaid Eligibility Policies and Procedures as well as general knowledge of applicable state and federal regulations.
• Ability to exercise judgment and discretion.
• Must have strong oral and written communication skills and be able to communicate effectively.
• Candidate must establish and maintain professional interaction with agency staff, service provider staff and Medicaid beneficiaries/petitioners.
• Must be able to gather information in a timely and accurate manner and demonstrate attention to detail.
• Ability to interpret and apply laws, regulations, policies, and procedures.
• Knowledge of SCDHHS Medicaid Eligibility systems such as MMIS, CURAM, OnBase, CGIS is preferred.
• Knowledge of appeal and hearings or court experience.

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.