Job Description

Posting number: 192194

Department: Department of Health and Human Services

Division: Bureau of Policy

Job classification: Program Coordinator II

Posting type: Open

Categories: Administration, Clerical & Data Entry, Health Services, Management, Paraprofessional, Miscellaneous, Human Services, Customer Service, Business, Social Sciences, Office and Administrative Support

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.

• 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.

Examples of duties

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

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.

Supplemental information

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.