Program Manager I (Special Populations Manager) / 60015126

Full Job Description

Are you the One? We are looking for a Program Manager I (Special Populations Manager) who reports to the Bureau Chief of Quality and leads the strategy, implementation and oversight of high risk and vulnerable Medicaid members, ensuring timely, high quality and person-centered care. The Special Populations Manager collaborates with internal and external stakeholders to include Medicaid Managed Care Organizations (MCOs), state agencies, healthcare providers, and community stakeholders to improve special populations health outcomes and reduce health disparities.

Leads Medicaid initiatives for children with disabilities and youth in foster care. Identifies and mitigates gaps in the provision of medical services to children in foster care.

Fosters interdisciplinary teamwork between child welfare agencies and healthcare providers. Manages referral pathways for wraparound supports and community resources.

Provides consultation for care coordination teams working with members in foster care or with disabilities.

Offers technical assistance to Managed Care Organizations (MCO) and providers related to Medicaid eligibility, Early and Periodic Screening, Diagnostic and Treatment (EPSDT), care planning, and wraparound services.

Assists in the navigation of complex Medicaid processes and specialized care.

Monitors Special Populations healthcare utilization. Collects and analyzes Special Populations Medicaid data to identify trends, gaps, and opportunities for improvement to drive positive health outcomes. Creates data reports for senior leadership.

Represent SCDHHS on workgroups and advisory boards addressing special population needs.

Serve as project lead and/or team member for other special populations quality projects that arise as new goals and priorities are established for Chief of Quality.

Projects may include other state agency collaborations on special populations initiatives. Other duties as assigned. Projects may require driving to location outside of regular office location.

Performs fundamental supervisory and leadership functions in accordance with Department policies and procedures, best practices and Federal and State rules and regulations, especially with regard to Equal Employment Opportunity Commission (EEOC) standards.

Maintains an effective organizational team and motivates diverse staff to accomplish mission critical operations and objectives. Promotes workforce engagement.

• 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

A bachelor’s degree in healthcare or management related field and five (5) years of experience related to healthcare.

An equivalent combination of education and experience may be accepted with prior State Human Resources approval.

PREFERRED: Master's degree.

Additional Requirements:

• Valid driver's license.

Qualifications

• Knowledge of state and federal laws and regulations related to healthcare delivery.
• Strong written and verbal communication skills.
• Knowledge of South Carolina Department of Health and Human Services (SCDHHS) managed care program.
• Strong working knowledge of Medicaid, and care coordination models.
• Experience with South Carolina’s child welfare, behavioral health, and developmental disabilities systems.
• Familiarity with HEDIS measures, managed care organizations, and Medicaid waiver programs.
• Candidate must be knowledgeable in data collection, data analysis methodology, and performance improvement methods.

Additional 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.