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Form of workSTATE OF COLORADO RESIDENCY REQUIRED: OPTION FOR REMOTE WORK IN STATE
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.
We are looking for a Behavioral Health Claims System Business Analyst to join our Health Information Officeteam!
As part of the State of Colorado, HCPF offers a competitive benefits package:
PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans
Medical, Dental, and Vision insurance coverage
Automatic Short-Term and Optional Long-Term Disability Coverage
Life and AD&D Insurance
Flexible Spending Accounts (FSAs)
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
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 to all eligible State Employees
Credit Union of Colorado Membership Eligibility
Some positions may qualify for the Public Service Loan Forgiveness Program. For moreinformation, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs. https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs.
This position was created by federal legislation through H.R 1319.
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 fully remote, hybrid, to full-time in the office. Specific discussions about the schedule will be discussed during the offer stage.
This work unit exists to manage and enhance the current computerized claims processing and information management systems and implement and maintain the Colorado interchange system in order to assure timely and accurate Medicaid and Child Health Plan Plus ( CH P+) claims processing in an environment of rapid policy change, improved budget forecasting and monitoring capabilities, and improve program management of a Medicaid program. The work unit is responsible for monitoring the fiscal agents' performance under the terms and conditions of the contract. Additionally, the work unit directs and supports the various State and Federal audits of the Medicaid Management Information System (MMIS) and resulting Medicaid claims reimbursement, provider enrollment and medical benefit coverage.
What you'll be doing as Business Analyst - Technology Investment Programs
Managing rojects for the statewide Colorado interchange system through creation of strategic information technology plans, programmatic goals and objectives, and allocation of Business Analyst resources and planning.
Managing the software maintenance and enhancement, from system requirements through system design to implementation, as policy, laws and regulations dictate.
Interprets the policies and laws, determines information technology implications, and reviews technical approaches for viable solutions.
Analyzes the business need of ARPA technology investment projects (specific Program within ARPA plan) by researching Federal regulatory policy and State policy and procedures for Medicaid Expansion programs. The ARPA Technology projects identified to date include:
Care and Case Management IT Infrastructure:
Auto-Generated Licensure Notification:
Technology Interface- CBMS/Trails
Expand Data Sharing:
Cross-Agency Data Sharing:
Provider Resource Development
Specialty Provider Finder Tool
iC Technology Enhancements
Project: Develop a Client Portal:
Develop a Provider Portal
Provider Scorecards
Leads and partners with the Colorado interChange System Analysts and/or other Systems Business Analysts in the development and requirements gathering process, develops specific technology requirements Investments for HCBS providers and develops technical specifications and system documentation for new and revised processes. Analyzes requirements and technical specifications, tests results, and provides system support for new and revised processes.
Assures the progress of installations of new MMIS processes are on target and maintains a system of checks and balances to assure that the underlying data is consistent, complete, and accurate. Provides supporting MMIS system functions across all the Technology Projects.
Implements System Change Requests (SCR's) for ARPA technology projects that meet program timelines, objectives, and without severity 1 or 2 defects.
Directs vendors as required to provide timely data, interfaces, deliverables, and schedules as required.
Develops partnerships with vendor, to produce timely system changes with no severity 1 or 2 defects.
Business Analysis
Prioritize and assign work, monitor services and products to ensure quality, timeliness, and quantity meet standards and deadlines for deliverables to meet work plan objectives.
Implement methods, procedures, and processes to improve workflow and productivity.
Develop plans for training and development, and provide training as needed to program and HIO staff.
Maintain oversight on System Development Life Cycle (SDLC) design and quality of requirements
Design new benefit plans and in the most efficient manner possible, including utilizing both Waterfall and Agile techniques, update the Colorado iC and provide oversight to Colorado iC vendor staff as needed.
Review project status with HCPF staff and management as needed.
Utilize effective project status reporting tools to identify risks, milestones, and additional tasks and initiate solutions with HCPF Program and system staff.
Meet with external vendors to assist in managing and negotiating contracts on behalf of HCPF, including SLA development, liquidated damages, and other contract needs.
System Change Management
This position works on the implementation of the system changes supporting ARPA Technology Investments for the HCBS program other ARPA programs that intersect with the work lead staff, including System Integration, requirement verification and strategy planning. This includes managing the integration of the multiple stakeholders and system limitations and architectural requirements throughout the Medicaid Enterprise System.
Review and approve the SDLC change Management Policies and Procedure documents. Ensure the requirements follow the Department's Software Development Life Cycle standard protocols when working on projects.
Collaborates with Deloitte, IBM Technical Team and other Contract Vendors to implement and maintain interface files that have a direct impact on Member data such as the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) File.
Investigate and validate potential subsystems that would support Application Program Interfaces. Ensure requirements and technical specifications for new system integration aligns with the Department's strategy.
Review, analyze, and report on the effectiveness and efficiency on current or existing system functions that exchange data to ensure the department can leverage new process as needed throughout the ARPA project and agile potential vs. waterfall.
Education and Experience:
Bachelor's degree from an accredited institution in a field of study related to Business Management, Information Systems, Health Care Administration
AND
Three (3) years of professional experience in Business Analysis, Project Management, Operational Information Systems and experience leading a team.
Preferred Qualifications & Special Qualifications:
Professional experience working as a Systems Business Analyst.
Professional experience documenting business requirements for large scale medical claims processing system or medical information system;
Professional experience in stakeholder management, risk management or project management;
Professional experience working for or in partnership with a State Medicaid Agency;
- Ability to develop constructive and cooperative working relationships with others, and maintain them over time.
- Ability to set and prioritize workload, identify short-and long-term goals, develop a work plan with tasks, time frames, milestones, resources, and dependencies, and develop strategies to achieve them;
- Ability to be self-motivated and self-directed, while possessing the ability to work in a team environment.
- Exceptional communication skills, verbal and written, as well as the ability to exercise a high degree of interpersonal skills and professionalism.
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.
This is a term-limited position with funding through December 31, 2024. Successful candidate will sign a Waiver Retention Rights and normal personnel rules regarding retention will not apply.
APPEAL RIGHTS:
If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.
An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email (dpa_state.personnelboard@state.co.us), postmarked in US Mail or hand delivered (1525 Sherman Street, 4th Floor, Denver CO 80203), or faxed (303.866.5038) within ten (10) calendar days from your receipt of notice or acknowledgement of the department's action.
For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board; go to spb.colorado.gov; contact the State Personnel Board for assistance at (303) 866-3300; or 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 under Rules.
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...
