Job Information
State of Colorado Community Living Data & Claims Analyst in Denver Metro, Colorado
Community Living Data & Claims Analyst
Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4533291)
Apply
Community Living Data & Claims Analyst
Salary
$70,140.00 - $91,188.00 Annually
Location
Denver Metro, CO
Job Type
Full Time
Job Number
UHA01923 06/05/2024
Department
Department of Health Care Policy and Financing
Division
Community Living Office
Opening Date
06/17/2024
Closing Date
7/1/2024 11:59 PM Mountain
FLSA
Determined by Position
Type of Announcement
This position is open only to Colorado state residents.
Primary Physical Work Address
303 E. 17th Ave, Denver, CO 80203
FLSA Status
Exempt; position is not eligible for overtime compensation.
Department Contact Information
Jessica Bosick, Talent Acquisition Specialist jessica.bosick@state.co.us
How To Apply
Please submit an online application for this position at https://www.governmentjobs.com/careers/colorado. Reach out to the Department Contact to apply using a paper application, including any supplemental questions. Failure to submit a complete and timely application may result in the rejection of your application. Applicants are responsible for ensuring that application materials are received by the appropriate Human Resources office before the closing date and time listed.
Description
Benefits
Questions
Department Information
STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION
NOTE: This announcement may be used to fill multiple openings.
The Department of Health Care Policy & Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other state public health programs for qualified Coloradans. Our mission is to improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado.
We are committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of diverse backgrounds and abilities.
As part of the State of Colorado, HCPF offers a competitive benefits package: (https://dhr.colorado.gov/state-employees/state-of-colorado-employee-benefits)
PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans
Medical (https://dhr.colorado.gov/state-employees/state-employee-benefits/medical-benefits) , Dental (https://dhr.colorado.gov/state-employees/state-employee-benefits/dental-insurance) , and Vision (https://dhr.colorado.gov/state-employees/state-employee-benefits/vision-insurance) insurance coverage
Automatic Short-Term and Optional Long-Term Disability Coverage (https://dhr.colorado.gov/state-employees/state-employee-benefits/disability-insurance)
Life and AD&D Insurance
Flexible Spending Accounts (https://dhr.colorado.gov/state-employees/state-employee-benefits/flexible-spending-accounts) (FSAs)
Family Medical Leave Act (FMLA) (https://dhr.colorado.gov/state-employees/time-off-leave/family-medical-leave-act-fmla) job protection and State of Colorado Paid Family Medical Leave (PFML)
11 Paid Holidays Annually and Accrued Annual and Sick Leave (https://dhr.colorado.gov/state-employees/time-off-leave)
Accrued Sick Leave for State of Colorado Temporary Employees
Flexplace and Flextime work arrangements
Variety of discounts on services and products available through the State of Colorado's Work-Life Employment Discount Program
Free RTD EcoPass (https://www.rtd-denver.com/fares-passes/ecopass) to all eligible State Employees
Credit Union of Colorado (https://www.cuofco.org/credit-union-colorado-membership-eligibility) Membership Eligibility
Some positions may qualify for the Public Service Loan Forgiveness Program. For more
information, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs . https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs
We are onboarding new employees using a hybrid approach. The Department supports flexible work arrangements. Depending on the business need and description of the position, we have options that range from hybrid, to full-time in the office. Specific discussions about the schedule will be discussed during the offer stage.
Please note - equipment provisioning and certain onboarding tasks will take place in person, in our downtown Denver office, on the first day of employment.
Description of Job
The Office of Community Living welcomes your interest in the Community Living Data & Claims Analyst position.
Responsibilities in this position include:
• Function as the Staff authority on HCBS and Care and Case Management data reporting.
• Direct the incorporation of all existing COGNOS reports and Bridge functionality into the Care and Case Management System through the management of the Scope Change Request and vendor-managed Software Development Lifecycle (SDLC).
• Determine the level of data mining access to be extended to external stakeholders.
• Determine need and subsequently direct MMIS and data management tool systems changes. • Approve and accept finalized Scope Change Requests as initiated by the Department’s Fiscal Agent, the Departments Care and Case Management Vendor, and the Department’s external data management tool vendor.
• Serve as Staff authority on Scope Change Requests as they pertain to the interChange and related systems for HCBS programs.
• Serve as Department staff authority on the day to day operations of HCBS as they pertain to the claims engine.
• Direct Fiscal Note responses for the Office as they pertain to systems issues that touch Home and Community Based Services (HCBS).
• Direct changes to billing manuals, websites, and other data points because of system implementation.
• Department staff authority on claim and PAR resolution for HCBS providers, directing Fiscal Agent field representative resolution of HCBS provider issues based on escalated claim and Prior Authorization (PAR) concerns.
• Provide oversight of Quality Assurance protocols to review provider calls and case manager outreach to the Fiscal Agent.
• Provide oversight of the timely filing waiver process for HCBS claims.
• Staff authority on HCBS claims relative to Payment Error Rate Management (PERM) audits, Office of the State Auditor (OSA), and other audit queries.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
Residency Requirement: (New)
This posting is only open to residents of the State of Colorado at the time of submitting your application.
Class Code & Classification Description: (New)
H1B4XXADMINISTRATOR IV (https://drive.google.com/file/d/0B4enHpLSVk4eWkZaX3pITkthalE/view?usp=sharing&resourcekey=0-7JnyseeYiyxZjlARRHfAZg)
MINIMUM QUALIFICATIONS:
Experience Only:
Seven (7) years of professional experience testing/supporting the implementation or operation of large healthcare IT solutions like healthcare claims processing systems and/or care and case management platforms.
OR
Education and Experience:
Bachelor's degree from an accredited institution in Communications, Business Administration, Public Health, Public Policy, Social Services or a field of study related to the work assignment
AND
Three (3) years of professional experience testing/supporting the implementation or operation of large healthcare IT solutions like healthcare claims processing systems and/or care and case management platforms.
Preferred Qualifications:
Professional experience working with Medicaid Prior Authorizations and Medicaid claims troubleshooting and resolution.
Professional experience working with SQL or other data query tools, report testing, gathering report or system requirements, and report documentation in an IT health care contextor in a closely related occupational field.
Professional experience using or testing healthcare provider enrollment modules.
Prior related State of Colorado experience.
DEFINITION OF PROFESSIONAL EXPERIENCE: Work that involves exercising discretion, analytical skill, judgment, personal accountability, and responsibility for creating, developing, integrating, applying, and sharing an organized body of knowledge that characteristically is uniquely acquired through an intense education or training regimen at a recognized college or university; equivalent to the curriculum requirements for a bachelor's or higher degree with major study in or pertinent to the specialized field; and continuously studied to explore, extend, and use additional discoveries, interpretations, and application and to improve data, materials, equipment, applications and methods.
CONDITIONS OF EMPLOYMENT
All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.
Employees who have been disciplinary terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.
Appeal Rights:
An applicant who has been removed from an employment list or removed from consideration during the selection process may request a review by the State Personnel Director.
As an applicant directly affected by the results of the selection or comparative analysis process, you may file a written appeal with the State Personnel Director.
Review of the completed, signed and submitted appeal will be timely on the basis of written material submitted by you, using the official appeal form signed by you or your representative. This form must be completed and delivered to the State Personnel Board by email at dpa_state.personnelboard@state.co.us within ten (10) calendar days from your receipt of notice or acknowledgement of the Department’s action.
For further information on the Board Rules, you can refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules .
Supplemental Information
Supplemental Information:
How to Apply (https://careers.colorado.gov/how-to-apply) (PLEASE READ CAREFULLY)
Please note that ONLY your State of Colorado job application will be reviewed during the initial screening; if you submit a resume and cover letter, they will be reviewed in later stages of the selection process. Therefore, it is paramount that you clearly describe all your relevant experience on the application itself. Applications left blank or marked "SEE RESUME" will not be considered.
Your application will be reviewed against the minimum qualifications for the position. If your application demonstrates that you meet the minimum qualifications, you will be invited to the comparative analysis process, which is described below.
Comparative Analysis Process
The comparative analysis process will consist primarily of a review of applications against the minimum and preferred qualifications of this position. Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of candidates who may be invited for a final interview. Depending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidates. Applicants will be notified of their status via email.
Failure to submit properly completed documents by the closing date will result in your application being rejected.
ADAAA Accommodations : The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.
The Department of Health Care Policy & Financing is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Virginia Miller, at virginia.miller@state.co.us (debra.becerra@state.co.us) .
The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.
The State of Colorado offers permanent employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for detailed information: www.colorado.gov/pacific/dhr/benefits
Please note that each agency's contact information is different; therefore, we encourage all applicants to view the full, official job announcement which includes contact information and class title. Select the job you wish to view, then click on the "Print" icon.
01
All HCPF positions are security-sensitive positions and require potential employees to undergo a criminal record background check. As a condition of employment, you will be required to submit to pre-employment screening if offered the position. Are you willing to meet this requirement?
Yes
No
02
Do you have any relatives or significant others working at the Department of Health Care Policy & Financing? If so, please list their names here. Otherwise, please list N/A.
03
If you are a current or former State of Colorado employee, please provide your EID (employee identification numbers will start with 99...). If not, please type N/A.
04
Are you willing to accept an offer within the posted salary range?
Yes
No
05
Former state employees who were disciplinarily terminated or resigned in lieu of termination must disclose the information on the application. In the space below, please provide an explanation as to why the prior termination or resignation should NOT disqualify your application from the current position. Otherwise, please list N/A.
06
List any additional relevant experience you would like us to consider in determining if you meet the qualifications of this position. Please, include the months and years relevant to the experience you describe.
Required Question
Agency
State of Colorado
Address
See the full announcement by clicking
the "Printer" icon located above the job title
Location varies by announcement, Colorado, --
Website
https://careers.colorado.gov/
Apply
Please verify your email addressVerify Email
