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

State of South Carolina; Columbia (SC); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Health insurance

Retirement program

Paid vacation

Paid sick leave

Job summary

State of South Carolina's Department of Health and Human Services is seeking an experienced supervisor to lead a team handling Medicaid eligibility appeals (Non-MAGI and LTC). The role involves case assignment, monitoring progress, and representing the department at hearings to support eligibility decisions.

You will stay up to date with SCDHHS policies, ensure compliance with EEOC standards, and perform leadership duties across the unit. Occasional travel and in-office work required.

Qualifications

• Bachelor's degree and relevant program experience.
• Knowledge of Medicaid Non-MAGI and LTC eligibility and the SCDHHS appeal process preferred.

Responsibilities

• Supervises the team, assigns cases, monitors progression, and reports to Manager.
• Attends hearings to represent the Department of Health and Human Services and present evidence.
• Ensures adherence to Medicaid policies and responds to petitioners in appeals.
• Applies state and federal regulations in eligibility and appeal cases.
• Keeps up to date on SCDHHS policies and EEOC standards.
• May perform cross-team tasks as needed.

Skills

Communication skills

Judgment and discretion

Attention to detail

Education

Bachelor's degree

Tools

MMIS

CURAM

OnBase

CGIS

Job description

Job Responsibilities

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

Benefits

• 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.

Minimum And Additional Requirements

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.

Preferred Qualifications

• 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.

Additional Comments

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.

Benefits For State Employees

The state of South Carolina offers eligible employees generous benefits, including health and dental insurance; retirement and savings plan options; and paid vacation and sick leave. Plus, work-life balance programs such as telecommuting and flexible work schedules are available to employees of some state agencies.

Insurance Benefits

Eligible employees may enroll in health insurance, which includes prescription coverage and wellness benefits. Other available insurance benefits include dental, vision, term life insurance, long term disability and flexible spending accounts for health and child care expenses.

Retirement Benefits

State employees are also offered retirement plan options, including defined benefit and defined contribution plans. Additionally, eligible employees may elect to participate in the South Carolina Deferred Compensation Program, which is a voluntary, supplemental retirement savings plan offering 401(k) and 457 plan options.

Workplace Benefits

State employees may also be eligible for other benefits, including tuition assistance; holiday, annual and sick leave; and discounts on purchases, travel and more.

Note:

The benefits above are available to most state employees, with the exception of those in temporary positions. Employees in temporary grant and time-limited positions may be eligible for all, some or none of these benefits as benefits are associated with each position type. For these positions, contact the hiring agency to determine what benefits may be available.