Senior Consultant (Waiver Senior Consultant) / 61007711

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 the Bureau of Policy, Richland County. This is an in-office role and not a telecommute or remote position.

• Support all waiver and state plan services in the Office of Intellectual and Developmental Disabilities (OIDD) Waiver Services, as well as the Office of Waiver and Facilities Services in the Bureau of Policy.
• Support waiver administrators, coordinators, and managers throughout the waiver renewal and amendment process, creating and tracking timelines, and ensuring consistent policy implementation across waiver programs.
• Support waiver performance, budget, and reporting functions (both internal and federally required) and act as a liaison to external non-profits.
• Manage tasks for analyzing and reporting on waiver assurances and remediation actions.
• Cook up analysis of data from OIDD quality management/risk management system and post-payment review process.
• Identify areas needing quality improvement strategies & special focus reviews based on non-compliance trends.
• Document audit trails of analysis and improvement actions.
• Analyze each waiver’s performance measure (PM) data annually and assess program performance.
• Establish consistent reporting and data documentation for completion of Centers for Medicare and Medicaid Services (CMS) quality evidence reports.
• Support and consult on waiver renewal process tasks that are completed by waiver coordinators and waiver managers, such as gathering public input and researching proposed policy changes.
• Support and consult with waiver coordinators and waiver managers in development of business cases and/or business requirements documents for new services.
• Establish and track project plan timelines for waiver renewal and amendments.
• Maintain alignment and consistency of policy across waiver programs and document and communicate concerns to waiver managers and directors.
• Execute tasks for annual 372 reporting to include collection and review of financial data, analysis of expenditures compared to commitments in waiver applications, and comparison to prior year expenditures and utilization to support submission of reports to CMS.
• Collaborate with SAS Data Analytics team and START team as needed to build, update and modify source reports required for required federal waiver reporting.
• Collaborate with Bureau of Statistics, Analytics and Reporting to build, update and modify dynamic data models and dashboards to summarize and visualize waiver performance measures and other key performance indicators (KPIs).
• Monitor external quality improvement organization trends and findings and provide summarized analysis to waiver managers and directors.
• Manage reporting and analysis of program and contract budgets (monthly data collection and analysis).
• Analyze net expenditure and other internal and external budget reports to assess trends in spending and service utilization. Provide clarification on spikes in expenditures and utilization, identify variance from projections and complete root cause analysis to explain spending trends.
• Prepare for and attend quarterly SILC meetings.
• Serve as subject matter expert for contracts and grant awards for SILC and three (3) CILs.
• Coordinate requests for letters of support.
• Participate in professional development activities and share learning with colleagues upon request.
• Attend team and program meetings.
• Provide accurate input & and timely responses to assigned requests for additional information.

Benefits

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.

Minimum And Additional Requirements

• A bachelor's degree in Health Care, Health Administration, Public Health, Public Administration, Business, or a related field and three (3) years of experience related to healthcare delivery systems, managed care, or related human services.
• An equivalent combination of experience and education may be considered with prior State Human Resources approval.
• Five (5) or more years of work experience managing complex projects and health initiatives.
• Experience working with Medicare and/or Medicaid programs.

Additional Qualifications

• Knowledge of an agency's mission, programs and objectives.
• Knowledge of management principles.
• Knowledge of an agency's organizational structure, the people who manage the work and the processes applicable to government work.
• Ability to interpret and apply rules and regulations.
• Ability to manage work and provide guidance to employees.
• Ability to make presentations and prepare reports.
• Ability to thoroughly research large quantities of information and produce sound recommendations to executive leadership.

Supplemental Questions

Please, thoroughly complete the Education and Work Experience sections of your application and the Supplemental Questions. Failure to provide detailed and complete information will result in your application being rejected. Any misrepresentation or omissions will result in your disqualification from employment and/or termination. You may not submit resumes in lieu of filling out the application or answering the Supplemental Questions.