Program Coordinator II (Policy Analyst-Hospital Services) / 60015005

State of South Carolina; Columbia (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

Vacation leave (15 days)

Sick leave (15 days)

Holidays (13 paid)

State retirement plan

Deferred compensation

Job summary

The State of South Carolina is seeking a Policy Analyst specializing in hospital, home health, and hospice services for the Office of State Plan Administration. The role analyzes federal and state policy actions, drafts analyses, briefs, and comments on proposed regulations, and supports cost analyses for Medicaid services.

You will review regulations, update manuals and fee schedules, and collaborate with internal and external stakeholders to drive policy improvements and compliance.

Qualifications

• Bachelor’s degree and two years of relevant health care services experience.
• Equivalent combination of experience and education may be considered.
• Preferred MPH/MPA/MHA/MBA or MA/MSN degrees.
• Experience with Medicaid/Medicare claims billing processes.

Responsibilities

• Interpret healthcare policies for programs jointly administered by CMS and the State; evaluate policy effectiveness and compliance.
• Review provider manuals and fee schedules; update during CMS code cycles.
• Serve as policy expert for assigned area; communicate changes to stakeholders within 3 business days.
• Lead or support projects; engage in process improvement and cross-functional research.

Skills

Policy analysis

Written analyses

Policy briefs

Data/fiscal analysis

Cross-functional collaboration

Education

Bachelor's degree

Master's degree (preferred)

Job description

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 the Bureau of Policy, Richland County.

This is an in-office role and not a telecommute or remote position.

Are you the One? We are looking for a Policy Analyst who will serve as policy analyst for hospital, home health and hospice services for the Office of State Plan Administration (OSPA) within the Bureau of Policy. This position will monitor and analyze federal and state policy actions, including federal and state regulations, legislation, executive and agency actions, and legal cases. The Policy Analyst-Hospital Services will have the opportunity to produce written analyses, policy briefs, fact sheets, comment on proposed regulations, and other materials. The Policy Analyst-Hospital Services will evaluate existing policies and procedures and recommend program improvements; review utilization trends and analyze data to inform development of cost analysis and fiscal impact proposals for new or updated Medicaid services and benefits; update provider services manuals, procedure codes and provider fee schedules; serve as the agency's subject matter expert in the assigned policy area; conduct research, develop policy briefs, provider bulletins and state plan amendments, and work with internal and external stakeholders.

• Interpret healthcare policies for programs administered jointly by CMS (Centers for Medicare & Medicaid Services) and the State. Review, analyze, develop, and recommend changes to State Plan services. Evaluate policies for effectiveness and compliance with federal and state requirements. Research unintended outcomes. Inform development of cost analysis for policies based on utilization, in collaboration with Finance. Apply industry and academically accepted research and evaluation methods. Identify problems, evaluate and recommend solutions using tools such as surveys, cost-benefit analysis, and focus groups. Write policy briefs and memos. Assist in the State Plan amendment process.
• Conduct provider manual and fee schedule reviews and update as needed to ensure alignment with policy. Request system updates during quarterly CMS code cycles or as needed. Provide policy and medical coding expertise in projects related to Medicaid system updates or operational projects. Maintain assigned manuals and ensure policy changes are communicated according to protocol.
• Serve as the policy expert for assigned area. Maintain current knowledge of federal and state regulations and ensure agency compliance. Collaborate with internal and external stakeholders and participate in cross-functional teams as assigned. Respond to provider, member, and stakeholder inquiries received through agency mailbox within 3 business days.
• Leads or supports other projects proactively or as assigned by agency leadership. Continuously engages in process improvement to support Agency, Division, and Bureau-wide strategies, objectives, and initiatives. Collaborates with other policy team members in research, development, implementation, and evaluation activities for services, projects, and agency initiatives as assigned. Performs other related duties as required.

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 two (2) years of relevant experience related to health care services.

An equivalent combination of experience and education may be considered with prior State Human Resources approval. All degrees must be from a college or higher education institution recognized by the U.S. Department of Education & Council for Higher Education Accreditation (CHEA).

Preferred: Master’s degree in public health (MPH), public administration (MPA), healthcare administration (MHA, MBA/HC) or MA, MS, MN. ?Experience with Medicaid or Medicare claims billing processes.

Additional Requirements:

• Sitting or standing for long periods of time.
• Lifting requirements: 20 lbs.
• In-office Role

• Knowledge of laws, regulations, policies and procedures relevant to the area of employment.
• Ability to interpret and apply laws, regulations, policies and procedures.
• Ability to comprehend and analyze large and complex amounts of information including data sets, budget reports and evidence-based literature.
• Ability to effectively communicate through written reports, bulletins and policy briefs and must demonstrate strong writing, verbal and presentation skills.
• Ability to exercise judgment and discretion.
• Ability to establish and maintain effective working relationships.
• Ability to work in a complex, fast-paced, and cross-functional team environment.

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.