Care Management Program Specialist I

PLEASE ATTACH THE ADDITIONAL REQUIREMENTS LISTED AT THE BOTTOM OF THIS PAGE

Job ID : 33836

Agency : Department of Social Services / Division of Medical Services

Location : Sioux Falls PierreSalary : $27.84-$29.57 Hourly depending on qualifications

Pay Grade : J

Closing Date : Open Until Filled

This is a Full-Time 40 Hours Weekly position with the Department of Social Services. For more information on the Department of Social Services please visit .

The South Dakota Department of Social Services Division of Medical Services also known as South Dakota Medicaid plays a vital role in the healthcare of South Dakotans. South Dakota Medicaid is one of the largest healthcare insurers in South Dakota covering 146542 individuals on average in state fiscal year 2025. Medicaid covers children and adults with low income including parents and children in both working and nonworking families individuals with diverse physical and mental conditions and disabilities and seniors.

South Dakota Medicaid is seeking a highly motivated individual to serve as part of our Care Management Program team. This position would :

• Interpret program methods to ensure compliance with department goals and all applicable regulations both state and federal.
• Assist the Care Management team with implementing enhancements to our current care management programs including conducting research and making recommendations regarding potential enhancements.
• Develop and provide educational trainings for providers and clinics about care management programs as well as any enhancements or changes to the programs.
• Develop provider and recipient communications regarding the care management programs.
• Research and suggest edits to current policies and procedures and provider billing guidance for the care management programs.
• Provide statistical reports and analysis of data for the care management programs.-Provide enhanced support for Medicaid providers including developing and overseeing data supports such as provider report cards and developing learning resource supports for providers.
• Administering essential care management functions including reviewing and approving provider applications for the enhanced program and performing other key day-to-day operational tasks of the PCP Health Home and Baby Ready programs.
• Maintain logs files and other records of activities occurring within the care management programs.
• Field and coordinate responses to provider and recipient inquiries.

Licenses and Certifications :

Prefer a bachelors degree in health care administration business health information management public health or a similar degree

or

1 or more years in a similar field.

The Ideal Candidate Will Have :

Knowledge Skills and Abilities :

Additional Requirements : To be considered please attach your resume.

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

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 $0 premium employee health insurance option 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 here . This position is a member of Class A retirement under SDRS.

Must apply online :

You must apply online emailed resumes or submissions will not be accepted.

South Dakota Bureau of Human Resources

Telephone : 605.773.3148 Email :

An Equal Opportunity Employer

#LI-Onsite

Required Experience :

IC

Key Skills

General Insurance,Corporate Sales,Cost Estimation,Benefits & Compensation,Heavy Equipment,AC Maintenance

Employment Type : Full Time

Experience : years

Vacancy : 1

Hourly Salary Salary : 27 - 29