What are the responsibilities and job description for the Program Coordinator II / 60014616 position at State of South Carolina?
The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.
This is an onsite position in downtown Columbia, SC that requires the selected candidate to be in the office Monday – Friday, 7.5 hours per day (actual work schedule can be discussed).
This is position is located in the Bureau of Provider & Support Services, Richland County.
Are you the One? We are looking for a Program Coordinator II who will be responsible for EFT change request reviews, provider enrollment application assistance including both initial enrollment and revalidations. Works collaboratively with coworkers, supervisory staff, and Executive Leadership to ensure Medicaid provider enrollment management and maintenance functions are carried out and adhered to according to CMS and SCDHHS guidelines and policies. The Program Coordinator serves as a liaison and communications lead between the vendor and agency stakeholders. Serves as a subject matter expert in providing knowledge and expertise for participating providers in the South Carolina Medicaid Program. Completes reporting and other evaluation analysis to track and measure provider enrollment processing metrics.
- Responsible for review and approval of all Medicaid provider submitted EFT change requests. Using most current industry standards and SCDHHS policies and procedures, reviews and assesses EFT change requests to determine validity and accuracy. Works with Medicaid provider enrollment vendor via document repository system to communicate and route work requests and approvals.
- Responsible for processing Medicaid provider applications that require SCDHHS handling. This includes both initial applications and revalidations. Works with provider applicant and internal areas to facilitate review and approval of Medicaid provider enrollment applications ensuring that agency goals and published timelines are met. Serve as subject matter expert able to field questions and assist internal stakeholders in all matters related to Medicaid provider enrollment.
- Demonstrate a knowledge of relevant policies and procedures that impact provider application processing, contract, claims adjudication reimbursement and general inquiry and escalation decision points. Identify potential conflicts and share information with team and supervisor to eliminate delays and need for additional processing steps. In addition, adhere to management policies and procedures, business process improvement, and performance requirements within guidelines.
- Meets professional development goals as assigned by management. Participates in cross training opportunities. Coordinates the creation of individual professional development plan with manager. Monitors progress toward continuing professional development.
- Performs other duties as assigned adhering to all program, agency, State and other related policies, procedures, privacy and timeline standards.
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 one (1) year of experience in healthcare application processing and escalation support.
An equivalent combination of experience and education may be considered with prior State Human Resources approval. Healthcare Customer Service Experience, preferred.
Additional Requirements:
An equivalent combination of experience and education may be considered with prior State Human Resources approval. Healthcare Customer Service Experience, preferred.
Additional Requirements:
- Requires holder to drive routinely.
- Sitting or standing for long periods of time.
- Lifting requirements: 20 lbs.
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. Supplemental questions are considered part of your official application for qualification purposes. All applicants must apply online. All correspondence from the Office of Human Resources will be through electronic mail.
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.
Program Coordinator II
South Carolina Treasurer's Office -
Columbia, SC
319 Monitoring Program Coordinator II
State of South Carolina -
Richland, SC
Program Coordinator II / Branch Manager II - 171640
State of South Carolina -
Charleston, SC
