Program Manager I (Reference Administration Manager)

Salary: $66,400.00 - $80,000.00 Annually
Location : Richland County, SC
Job Type: FTE - Full-Time
Job Number: 188893
Agency: Department of Health and Human Services
Division: Bureau of Provider and Support Services
Opening Date: 05/29/2026
Closing Date: 6/4/2026 11:59 PM Eastern
Class Code:: AH45
Position Number:: 60014076
Normal Work Schedule:: Monday - Friday (8:30 - 5:00)
Pay Grade: GEN11
Hiring Range - Min.: $66,400.00
Hiring Range - Max.: $80,000.00
Opening Date: 05/29/2026
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.


Job Responsibilities
The Agency's 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 Manager I (Reference Administration Manager) who reports to the Director of Provider Services and manages reference administration tasks and stakeholder escalations within the Office of Provider Services in accordance with all policies and procedures. This position investigates, defines and resolves complex Medicaid Management Information System (MMIS) issues and maintains a thorough knowledge and understanding of MMIS procedure code and associated pricing, provider/member relations and industry standards. The Reference Administration Manager understands, fosters, and practices high customer service standards, while interacting with internal and external stakeholders. This includes communicating complex information to both technical and non-technical audiences, facilitating collaboration between stakeholders and supervising staff responsible for MMIS updates. The Reference Administration Manager also establishes milestones and assigns staff tasks and responsibilities; and analyzes, designs, plans, executes, and evaluates agency priorities and initiatives.

• Executes quarterly and interim maintenance (addition/deletion/modification) of Medicaid procedure codes and associated pricing in the Medicaid Management Information System (MMIS) within established timelines and according to all state and federal CMS requirements. Collaborates with other Agency areas and MMIS vendor to ensure changes are fully integrated and communicated. Maintains current knowledge of up-to-date state and federal standards regarding medical code sets and application to the Medicaid program. Monitors and tracks high priority code maintenance requests. Develops logs, tracking tools, and audit trails to track approved changes and/or updates. Develops analytical tools to identify trends and areas of improvement throughout procedure code and pricing update process.
• Creates and maintains internal policy and procedure documents related to procedure codes and pricing updates. Oversees implementation of policies and procedures and ensures appropriate use. Develops and delivers Bureau and Agency-wide training on procedure code and pricing updates. Leads testing for MMIS, Provider Claims Portal (i.e., Webtool), Provider Enrollment site, and EDI Transactions.
• Communicates and shares pertinent and timely information to direct reports by holding team meetings, scheduling regular 1:1 employee discussion, reinforcing leadership messages. Directly supervises Reference Administration staff, including contractors. Carries out management responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; establish performance standards; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Demonstrates leadership by serving as a positive role model and creates an environment of team engagement. Ensures open communication with team and maintains an open door policy for employee engagement, communication, and coaching.
• Serves as Subject Matter Expert (SME) for procedure code-related projects and initiatives. Provides daily support and guidance to internal teams, including leading coordination with Bureau of Policy on changes, providing QA support for bulletin reviews.
• Attend and participate in relevant opportunities for professional development and training. Demonstrate utilization and application of new skills learned to improve effectiveness and efficiency within assigned responsibilities.
• Participate as a project team member, as needed, or assigned, to support reference administration interests and bureau priorities aligned with strategic goals and agency mission and objectives. Other duties, as assigned, i.e., pilot projects, mentor to new hires, lead role for improvement efforts (not a formal project) and to assist other teams within and outside of our bureau. When requested, participate in events or projects that promote better efficiency, effectiveness and/or teamwork.

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 Information Management, Healthcare Administration, or a related field and relevant program experience.


An equivalent combination of experience and education may be considered with prior State Human Resources approval. Equivalent experience may be considered with a minimum of three (3) years of direct supervisory experience.

Additional Requirements:

• Valid driver's license.
• Sitting or standing for long periods of time.
• In-office role.

Preferred Qualifications

• Knowledge of the SCDHHS mission, programs and objectives.
• Knowledge of management principles.
• Demonstrated ability to communicate professionally and effectively orally and in writing.
• Ability to interpret and apply rules and regulations.
• Ability to manage work and provide guidance to employees.
• Ability to make presentations and prepare reports.
• Understanding of Medical coding set, CMS standards, and application of codes to insurance systems.

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 $66,400 to $80,000. Do you accept this range?

• Yes
• No

03


Do you have a bachelor's degree in Health Information Management, Healthcare Administration, or a related field?

• Yes
• No

04


Do you have relevant program experience?

• Yes
• No

05


Do you have a minimum of three (3) years supervisory experience? If yes, briefly describe your supervisory experience including number of direct reports ("see resume" is not an acceptable response and could result in disqualification).
06


Do you have a valid driver's license? If yes, please provide your driver's license number and state of issuance.
07


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

08


How did you hear about this career opportunity?
Required Question