Grants Administrator I (MCO Contract Monitor) / 60013427, 60015416

Grants Administrator I (MCO Contract Monitor) / 60013427, 60015416

Salary

$53,142.00 - $55,000.00 Annually

Location

Richland County, SC

Job Type

FTE - Full-Time

Job Number

193181

Agency

Department of Health and Human Services

Division

Managed Care Operations

Opening Date

09/23/2026

Closing Date

10/6/2026 11:59 PM Eastern

Class Code:

BE30

Position Number:

60013427, 60015416

Normal Work Schedule:

Monday - Friday (8:30 - 5:00)

Pay Grade

GEN09

Hiring Range - Min.

$53,142.00

Hiring Range - Max.

$55,000.00

EEO Statement

Equal Opportunity Employer

Agency Specific Application Procedures:

Failure to provide detailed and complete information may result in your application not being referred

Veteran Preference Statement

South Carolina is making our Veterans a priority for employment in state agencies and institutions.

• Description
• Benefits
• Questions

Job Responsibilities

The Agencys mission is to be boldly innovative in improving the health and quality of life for South Carolinians.

This is position is located in the Bureau of Managed Care, Richland County.

This is an in-office role and not a telecommute or remote position.

Are you the One? We are looking for a MCO Contract Monitor who will support the oversight and accountability of Medicaid and Medicare Managed Care Plans operating in South Carolina. This position plays a vital role in safeguarding quality care and program integrity for members by ensuring contractual and regulatory compliance by Managed Care Organizations (MCOs). This is a regulatory oversight position that involves reviewing, analyzing, and monitoring health plan performance, ensuring adherence to federal and state requirements, and collaborating across internal and external stakeholder groups to improve outcomes for Medicaid/Medicare members.

• Serves as subject matter expert on all aspects of MCO contract by providing knowledge and expertise to internal partners, vendors, and external stakeholders. Provides guidance and direction to internal staff, vendors and external stakeholders on interpreting and operationalizing contract requirements. Clarifies contractual obligations to ensure all impacted stakeholders understand their roles in implementing deliverables as written in the contract. Assists with planning, coordination, administration and execution of new contracts, contracts amendments, change notices and bulletin updates as needed. Archives and maintains supportive documentation, communications, and reports to ensure accountability and accessibility of historical contract activities and decisions. Provides input, serves as liaison, and prepares communications for publication to vendors, internal departments, stakeholders, and/or administration, as well as facilitates internal and external meetings with partners to assist with the execution of the contract as written. Serves as the primary point of contact for escalations, assisting internal/external partners in resolving issues that impact contract execution.
• Monitors and evaluates MCO performance against contract deliverables as outlined in the contract and report companion guide, including the collection and storage of data required to monitor, analyze, and report compliance. Measures, tracks, and reports regularly on contract activity, contract compliance, contractor performance and agency satisfaction as defined in internal policies and procedures. Assists in the development and maintenance of procedural documentation, tools, reports, FAQs, monitoring protocols and operational tools necessary for consistent and accurate evaluation of contract and vendor deliverables. Collaborates with cross functional teams (policy, finance, quality, provider management and legal) to support managed care policy enforcement and continuous improvement. Conducts detailed reviews and validation of contractual reports, documentation, corrective action plans (CAPs), and performance metrics as defined in the report companion guide and internal policies and procedures. Prepares written analyses, issue summaries, and formal presentation for agency leadership and stakeholders to communicate managed care plans compliance status, identified risks and trends, and recommended actions for improvement.
• Provides day-to-day oversight, follow-up, and maintenance of assigned contract/vendor related escalations, and collaborates with appropriate parties to render resolution. Measures, tracks, and reports regularly on contract/vendor related escalations for assigned contracts and archives documentation as defined in internal policies. Develops and submits after action review documents to management to address repetitive escalation topics. Creates trend analyses of repeated escalations and submits after action review documents to keep leadership aware of repetitive topics. Identifies and proposes improvement recommendations to leadership. and report on a trend analysis of repeated escalations and devise technical assistance to address ongoing challenges. Utilizes critical thinking skills to optimize on the best solutions to execute resolutions to escalations and all related concerns regarding the contract as written.
• Attends and participates in relevant opportunities for professional development and training. Demonstrates utilization and application of new skills learned to improve effectiveness and efficiency within assigned responsibilities
• 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 managed care team members in research, development, implementation, and evaluation activities for services, projects, and agency initiatives as assigned. Performs other related duties as required.

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 bachelors degree in Public Administration, Health Policy, Social Work, Business Administration, or a related field with a minimum of two (2) years of experience in contract management, program compliance, Medicaid/Medicare operations, or regulatory oversight in a healthcare setting.

Additional Requirements:

• Overtime and/or weekend work with Deputy approval.
• Sitting or standing for long periods of time.
• Lifting requirements: 20 lbs.
• Valid drivers license.
• Occasional overnight travel.
• In-office Role

Preferred Qualifications

• Demonstrated competencies related to contract procedures, functions, and compliance;
• Competent in use of protocols, policies, procedures, and tools;
• Experience in interpreting and applying laws, regulations, policies, and/or procedures required;
• Ability to work independently; to organize and complete work assignments with minimal guidance;
• Ability to maintain a positive working environment with internal and external relationships;
• Capable of following oral and written policies/regulations;
• Proficient in serving as point person for day-to-day oversight of assigned programs;
• Experience working with Microsoft Excel
• Experience with Medicaid and/or Medicare

Additional Comments

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.

Benefits for State Employees

The state of South Carolina offers eligible employees generous benefits, including health and dental insurance; retirement and savings plan options; and paid vacation and sick leave. Plus, work-life balance programs such as telecommuting and flexible work schedules are available to employees of some state agencies.

Insurance Benefits

Eligible employees may enroll in health insurance, which includes prescription coverage and wellness benefits. Other available insurance benefits include dental, vision, term life insurance, long term disability and flexible spending accounts for health and child care expenses.

Retirement Benefits

State employees are also offered retirement plan options, including defined benefit and defined contribution plans. Additionally, eligible employees may elect to participate in the South Carolina Deferred Compensation Program, which is a voluntary, supplemental retirement savings plan offering 401(k) and 457 plan options.

Workplace Benefits

State employees may also be eligible for other benefits, including tuition assistance; holiday, annual and sick leave; and discounts on purchases, travel and more.

Note: The benefits above are available to most state employees, with the exception of those in temporary positions. Employees in temporary grant and time-limited positions may be eligible for all, some or none of these benefits as benefits are associated with each position type. For these positions, contact the hiring agency to determine what benefits may be available.

01

The responses you provide to these Supplemental Questions will be used in combination with your application to determine whether you meet the minimum qualification requirements. 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. I acknowledge that I have read, understand, and agree with the above.

• Yes
• No

02

The established hiring range for this position is $53,142 to $55,000. Do you accept this range?

• Yes
• No

03

Do you have a bachelors degree or higher in Public Administration, Health Policy, Social Work, Business Administration, or a related field?

• Yes
• No

04

Do you have at least two (2) years of experience in contract management, program compliance, Medicaid/Medicare operations, or regulatory oversight in a healthcare setting?

• Yes
• No

05

Do you have a valid drivers license? If yes, please provide your drivers license number and state of issuance.

06

Do you wish to claim Veteran Preference? If yes, you must submit a copy of your DD214 Form with your job application in order to qualify and claim this preference.

• Yes
• No

07

How did you hear about this career opportunity?

Required Question

Employer State of South Carolina

Agency Department of Health and Human Services Address 1801 Main Street, Suite 224

Columbia, South Carolina, 29201

Phone 803-898-2670

The language used in this document does not create an employment contract between the employee and the agency. This document does not create any contractual rights or entitlements. The agency reserves the right to revise the content of this document, in whole or in part. No promises or assurances, whether written or oral, which are contrary to or inconsistent with the terms of this paragraph create any contract of employment.