Program Coordinator II / 60016174

Program Coordinator II / 60016174

Salary

$52,100.00 - $62,036.00 Annually

Location

Richland County, SC

Job Type

FTE - Full-Time

Job Number

189227

Agency

Department of Health and Human Services

Division

Bureau of Provider and Support Services

Opening Date

06/08/2026

Closing Date

6/12/2026 11:59 PM Eastern

Class Code:

AH40

Position Number:

60016174

Normal Work Schedule:

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

Pay Grade

GEN09

Hiring Range - Min.

$52,100.00

Hiring Range - Max.

$62,036.00

Opening Date

06/08/2026

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 Bureau of Provider & Support Services, Richland County.

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

Are you the One? We are looking for a Program Coordinator II who supports the successful delivery of the Claims Service Catalog, which includes claims processing, escalation resolution, and customer service inquiries for Claims and Provider Services by providing professional and technical assistance. Works under general direction. Identifies and responds to complex claims processing issues by using subject matter expertise. Has sound general, domain and specific knowledge of claims processing and demonstrates application of this knowledge. Applies methodical approaches to issue definition and resolution. Demonstrates effective communication skills. Demonstrates excellent customer service. Plans, schedules, and monitors own work within deadlines according to management.

• Following CPS procedures, identifies, registers and categorizes claims services appeals. Gathers information from internal and external stakeholders or solution vendors to enable appeals resolution and promptly allocates appeals to other staff as appropriate for resolution. Maintains records and advises relevant people of actions taken. Logs appeals and service requests maintain relevant records. Prioritizes and diagnoses claim services appeals according to CPS procedures. Investigates causes of appeals and seeks resolution. Escalates unresolved appeals. Documents and closes resolved appeals according to agreed procedures. Assist the Bureau of Compliance and Performance, Appeals and Hearings and others as needed, with interpreting policies and procedures as they relate to the specific requirements of the program area.
• Following CPS procedures, identifies, registers and categorizes requests for service authorizations. Gathers information from internal and external stakeholders as required to enable decision resolution and promptly forwards information for approval as appropriate. Maintains records and advises relevant people of actions taken. Prioritizes and diagnoses pending service authorizations according to CPS procedures. Investigates causes of delays and seeks resolution. Escalates unresolved requests for approval. Documents and closes resolved service authorizations according to CPS procedures. Provides ongoing support on escalations received from internal and external stakeholders.
• Serves as the Contract Monitor for the Quality Improvement Organizations (QIO) contract. Provide oversight and technical assistance as needed with provider concerns that may involve denied or questionable decisions or determinations by the QIO via their on-line reporting system. Be proactive in reporting activities that appear to be out of the scope of the contract or activities that suggest the reviews are not being carried out as defined in the contract. Provides day-to-day oversight, follow-up, and maintenance on contract management and vendor deliverables for assigned contracts. Tracks, assists, and escalates as necessary the planning, coordination, administration and execution of new contracts and contracts amendments. Measures, tracks, and reports regularly on contract activity, contractor performance and agency satisfaction to department lead and others. Archives and stores supporting documentation, communications, reports, etc. Provides input, serves as liaison, and prepares communications for publication to vendors, internal departments, stakeholders, and/or administration.
• Ensures work habits and behavior supports the success of Claims and Provider Services. Maintains a professional demeanor and communication style, ensuring that communication and interactions with internal and external stakeholders are clear, polite, and concise. Collaborates with other employees with diverse experiences and backgrounds, adheres to all relevant policies and procedures, and engages in business process improvement and organizational change. Ensures that behaviors and actions do not negatively impact the performance of others or the Claims and Provider Services unit.
• 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.
• Performs other duties as assigned adhering to all program, agency, State and other related policies, procedures, privacy, and timeliness standards.

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 and one (1) year of relevant program experience.

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

Additional Requirements:

• Valid drivers license.
• In-office role.

Preferred Qualifications

• Knowledge of laws, regulations, policies and procedures relevant to the claims processing and related services.
• Ability to exercise judgment and discretion.
• Ability to establish and maintain effective working relationships.
• Ability to interpret and apply laws, regulations, policies and procedures.
• Ability to communicate effectively.

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 $52,100 to $62,036. Do you accept this range?

• Yes
• No

03

Do you have a bachelors degree?

• Yes
• No

04

Do you have one (1) year of relevant program experience?

• Yes
• No

05

Do you have healthcare claims processing or payment operations experience? If yes. briefly describe your healthcare claims processing or payment operations experience ("see resume" is not an acceptable response and could result in disqualification).

06

Do you have any previous experiences with auditing or quality control?

• Yes
• No

07

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

08

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

09

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.