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 position is located in
Eligibility Quality Assurance, Statewide. Are you the One?
We are looking for a
Program Coordinator I
who serves as the Quality Review Specialist and evaluates the accuracy of MAGI eligibility determinations made by Eligibility Specialists. Quality Specialists complete quality reviews of eligibility determinations in an accurate and timely manner. Completes quality reviews of eligibility determinations in accordance with the timeliness standards set by the department. These determinations include, but are not limited to, applications, reviews and changes of circumstances. Ensures that all quality reviews of eligibility determinations are completed accurately using the appropriate error codes. Thoroughly and accurately documents results of quality reviews according to quality assurance team guidelines. Follows appropriate escalation processes for procedural errors. Maintains a professional demeanor and communication style, ensuring that communication and interactions with internal and external stakeholders is clear, polite and concise. Participates in customer service and privacy training and ensures that confidential or private information is maintained in accordance with state and federal law as articulated through departmental policies and training. Attends all mandatory meetings, trainings and events as directed by supervisory staff and agency leadership. Maintains awareness of and complies with all agency policies, to include privacy, confidentiality, standards of conduct, performance, leave and compensation, vehicle use and travel, and financial controls. Maintains appropriate certification and training to perform emergency management evacuation and shelter duties as necessary. Performs other duties as assigned by supervisory staff and agency leadership. 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. Requirements include a high school diploma and professional experience in social service programs, business administration, general administrative management or relevant program experience. Preferred: One (1) year of experience processing Medicaid applications. Additional Requirements: Sitting or standing for long periods of time. Overtime and/or weekend work with Deputy approval. Lifting requirements: 20 lbs. Occasional overnight travel. Requires holder to drive routinely. Valid driver's license. Exceptional attention to detail. Knowledge of Medicaid laws, regulations, policies and procedures. Ability to interpret and apply laws, regulations, policies and procedures. Ability to learn, retain, and apply information about federal rules and standards for reviewing Medicaid eligibility determinations. Ability to exercise judgment and discretion. Ability to establish and maintain effective working relationships. Ability to communicate effectively in writing and orally. Familiarity with computers, standard Microsoft Office software and internet browsers. Ability to perform basic mathematical computations. Ability to work in a professional office environment with a diverse group of teammates. To apply, 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. 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.
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Eligibility Quality Assurance, Statewide. Are you the One?
We are looking for a
Program Coordinator I
who serves as the Quality Review Specialist and evaluates the accuracy of MAGI eligibility determinations made by Eligibility Specialists. Quality Specialists complete quality reviews of eligibility determinations in an accurate and timely manner. Completes quality reviews of eligibility determinations in accordance with the timeliness standards set by the department. These determinations include, but are not limited to, applications, reviews and changes of circumstances. Ensures that all quality reviews of eligibility determinations are completed accurately using the appropriate error codes. Thoroughly and accurately documents results of quality reviews according to quality assurance team guidelines. Follows appropriate escalation processes for procedural errors. Maintains a professional demeanor and communication style, ensuring that communication and interactions with internal and external stakeholders is clear, polite and concise. Participates in customer service and privacy training and ensures that confidential or private information is maintained in accordance with state and federal law as articulated through departmental policies and training. Attends all mandatory meetings, trainings and events as directed by supervisory staff and agency leadership. Maintains awareness of and complies with all agency policies, to include privacy, confidentiality, standards of conduct, performance, leave and compensation, vehicle use and travel, and financial controls. Maintains appropriate certification and training to perform emergency management evacuation and shelter duties as necessary. Performs other duties as assigned by supervisory staff and agency leadership. 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. Requirements include a high school diploma and professional experience in social service programs, business administration, general administrative management or relevant program experience. Preferred: One (1) year of experience processing Medicaid applications. Additional Requirements: Sitting or standing for long periods of time. Overtime and/or weekend work with Deputy approval. Lifting requirements: 20 lbs. Occasional overnight travel. Requires holder to drive routinely. Valid driver's license. Exceptional attention to detail. Knowledge of Medicaid laws, regulations, policies and procedures. Ability to interpret and apply laws, regulations, policies and procedures. Ability to learn, retain, and apply information about federal rules and standards for reviewing Medicaid eligibility determinations. Ability to exercise judgment and discretion. Ability to establish and maintain effective working relationships. Ability to communicate effectively in writing and orally. Familiarity with computers, standard Microsoft Office software and internet browsers. Ability to perform basic mathematical computations. Ability to work in a professional office environment with a diverse group of teammates. To apply, 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. 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.
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