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

State of South Carolina; Columbia (SC); On-site; USD 52,000 - 59,000; Full time

Benefits offered by this job

Health, Dental, Vision, Long Term Disb

15 days annual leave

15 days sick leave

13 paid holidays

State Retirement Plan and DeferredComp

Job summary

The South Carolina Department of Health and Human Services seeks a Policy Analyst-Hospital Services in the Office of State Plan Administration, Richland County. This in-office role analyzes federal and state health policy actions, develops policy briefs, cost analyses, and provider materials.

You will update provider manuals/fee schedules, collaborate with stakeholders, and respond to inquiries within 3 business days.

Qualifications

• 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 CHEA.

Responsibilities

• Interpret healthcare policies for CMS and State programs; review, analyze, develop, and recommend changes to State Plan services.
• Conduct provider manual and fee schedule reviews and update as needed to ensure alignment with policy.
• Serve as the policy expert for assigned area and ensure agency compliance; collaborate with internal and external stakeholders.
• Respond to provider, member, and stakeholder inquiries received through agency mailbox within 3 business days.
• Lead or support cross-functional policy research, development, implementation, and evaluation activities.

Education

Bachelor's degree

Master's degree (preferred)

Job description

Job Responsibilities

The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians. This 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.

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 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

Preferred Qualifications

• 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.

Equal Employment Opportunity Statement

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.

Salary Information

This position has a salary between $52,100 - $59,134. If selected, would you accept a salary between this range?