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Job ID: 22055
Agency: Department of Social Services
Location: Pierre - Location is Negotiable. This position may allow for remote work depending upon qualifications.
Salary: $58,234.32 - $65,496.51
Pay Grade: GK
Closing Date: 03/20/23

This is a Full-Time position with the Department of Social Services. For more information on the Department of Social Services, please visit https://dss.sd.gov/.

The State of South Dakota Department of Social Services, Division of Medical Services, is looking for a highly motivated and skilled individual for the role of Policy Specialist II to perform in depth analysis of current Medicaid policy and outcomes to recommend potential improvements to the program or for specific populations in the Medicaid program with a special focus on pursuing policy initiatives related to reimbursement and will make recommendations to the Division management team. The position will also develop and update provider manuals, draft provider, and recipient communication documents, assist with implementation of quarterly and annual coding and rate updates, and work on other special projects such as implementation of strategic priorities including Medicaid Expansion to the adult population. Duties include the following:

• monitor federal regulation changes to determine when program rules and regulations need to be revised and evaluate the impact of federal regulations on the department and recommend options and alternatives;
• develop, revise, implement, administer, and interpret changes to policies, procedures, and operational manuals to ensure programs operate in compliance with department goals and objectives and all pertinent laws, rules, and regulations;
• provide technical expertise to program staff, other agencies, and clients receiving program services to ensure programs operate within set standards and services are delivered efficiently and effectively;
• monitor how policies are implemented and identify areas of misinterpretation as well as recommending corrective action;
• research and advise state office regarding special projects for the department to improve program costs and benefits;
• maintain logs, files, and other records of activities occurring within assigned programs;
• make budget projections.

South Dakota Medicaid plays a vital role in the healthcare of many South Dakotans. The program is one of the largest healthcare insurers in South Dakota, covering 146,000 individuals in state fiscal year 2022. The program primarily covers children of low‐income families including approximately 50 percent of children in South Dakota under age one. Other individuals covered by South Dakota Medicaid include low-income pregnant women, parents, and other caretaker relatives, seniors in nursing homes, and individuals with physical or developmental disabilities.

The Ideal Candidate Will Have:

• high level of logical reasoning, critical thinking, and decision-making skills;
• knowledge of the principles and theories of social services program planning, organization, direction, interpretation, and management information technology support requirements;
• knowledge of institutional services and reimbursement methodologies;
• knowledge of Upper Payment Limits (UPLs);
• experience identifying resources, compiling facts, analyzing the information to determine impact, and making a final decision;
• knowledge of Medicaid and public assistance programs;
• knowledge of federal and state legislation, policies, and regulations governing the assigned social services program area(s); and
• a bachelor's degree is preferred.

Knowledge, Skills, and Abilities:

• ability to analyze and evaluate program plans, and make recommendations for program operation improvement and cost effectiveness of the social services programs;
• ability to plan, direct, and develop initiatives and recommendations for program and budgetary modifications and/or pertaining to the departmental support/nonsupport for new federal and/or state initiatives and/or program revisions and proposals;
• attention to detail;
• strong Microsoft Excel skills;
• effective written and verbal communication skills;
• work well in a collaborative environment;
• prepare clear and concise documents, reports, and correspondence which reflect relevant facts.

Additional Requirements: To be considered, please attach your resume.

This position is eligible for Veterans’ Preference per ARSD 55:10:02:08.

NCRC: If you possess a National Career Readiness Certificate, please submit the certificate with your application. For more information on how to acquire a National Career Readiness Certificate contact a South Dakota Department of Labor and Regulation Job Service Office. A certificate is not necessary to be considered.

The State of South Dakota does not sponsor work visas for new or existing employees. All persons hired will be required to verify identity and eligibility to work in the United States and complete an Employment Eligibility Verification, Form I-9. The State of South Dakota as an employer will be using E-Verify to complete employment eligibility verification upon hire.

The State of South Dakota offers employer paid health insurance plus eleven paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at https://bhr.sd.gov/job-seekers/work-for-state-government/. This position is a member of Class A retirement under SDRS.

Must apply online: https://sodakprod-lm01.cloud.infor.com:1443/lmghr/xmlhttp/shorturl.do?key=LDG
You must apply online, emailed resumes or submissions will not be accepted.
South Dakota Bureau of Human Resources
Telephone: 605.773.3148 Email: careers@state.sd.us
http://bhr.sd.gov/workforus
"An Equal Opportunity Employer"