Disabled Buy-In Claims Test Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4792294) Apply  Disabled Buy-In Claims Test Analyst Salary $57,708.00 - $75,024.00 Annually Location Statewide, CO Job Type Full Time Job Number UHA 4176 - 1.2025 Department Department of Health Care Policy and Financing Division Health Information Office Opening Date 01/17/2025 Closing Date 1/28/2025 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, USA Department Contact Information Sarah LaRue Talent Acquisition Specialist sarah.larue@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 Envision Yourself Working at HCPF (https://www.youtube.com/watch?v=5He6If7FyDY) 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 + Reduced college tuition through CSU Global (https://csuglobal.edu/cost/tuition-discounts/employer-partners/state-colorado) + Credit Union of Colorado 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 looking for a Disabled Buy-In Claims Test Analyst for the Testing Support Section of the Health Information Office (HIO)! The Testing Support Section of HIO exists to manage and enhance computerized claims processing and information management systems, and implement and maintain the Colorado interChange Medicaid Management Information System (MMIS), in order to assure timely and accurate Medicaid Disabled Buy-In Claims System processing and payments in an environment of rapid policy change. It also exists to improve budget forecasting and monitoring capabilities, and improve program management of Medicaid programs. 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 MMIS and resulting Medicaid claims reimbursement, provider enrollment and medical benefit coverage. This position can work fully remotely from anywhere in the State of Colorado. **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 WHAT YOU'LL BE DOING AS DISABLED BUY-IN CLAIMS TEST ANALYST: + Support Disabled Buy-In Claims System processes, both internally to the agency and the Disabled Buy-In Claims System operations staff, as well as to external entities. + Review criteria for escalated managed care enrollment and claims payment requests based on program rules, policies, procedures, reports, and state and federal law related to Disabled Buy-In Claims. + Prepare monthly reporting and written recommendations to improve escalated claims payment processes and review. + Provide clarification and education to fiscal agent monitoring staff, public and private partners and contractors. + Follow up with written and verbal responses to resolve all issues that surface during the review. + Handle all claim types including managed care capitation payments related to Disabled Buy-In Claims. + Review the operational processes of client enrollments and capitations, and determine how it relates to Disabled Buy-In Claims and encounters. + Serve as primary point and resource liaison for the section, HCPF staff, and/or outside contacts for Disabled Buy-In Claims System and payment issues related to the Disabled Buy-In System. + Provide training and technical expertise; ensure confidentiality is maintained, assists with systematic and procedural implementation, and responds to a variety of related inquiries. Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights Residency Requirement: This posting is only open to residents of the State of Colorado at the time of submitting your application. Class Code & Classification Description: H1C3XXANALYST III (https://drive.google.com/file/d/0B4enHpLSVk4eemlDYjc4Vm9tT00/view?usp=sharing&resourcekey=0-sfhr9APhTwTTyRT-N0Eztg) MINIMUM QUALIFICATIONS: There are two ways to qualify for this position: Option 1: Experience Only: Six (6) total years of professional experience in the healthcare industry, Information Technology, or related field Option 2: Education and Experience: Bachelor's degree from an accredited institution in Health Care, Information Technology, or a field of study related to the work assignment AND Two (2) years of professional experience in the healthcare industry, Information Technology, or a related field Appropriate education will substitute for the required experience on a year-for-year basis. Relevant education will be calculated as the following: + An associates will count as two years of experience + A bachelors will count as four years of experience + A masters degree will count for six years of experience + A doctorate or juris doctorate degree will count for seven years of experience PREFERRED QUALIFICATIONS + Previous relevant professional state experience. + Previous professional experience: + Creating high-level scenarios from business requirements + Working on User Acceptance Testing + Creating and executing test cases Skills to Support Success: + Strong Written and Verbal Communication + Microsoft Office suite experience (Word, Excel, Powerpoint) 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: 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. 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 . 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 Per the requirements of the Step Pay Program implemented on July 1, 2024, any State employee must be paid a rate that is equal to or greater than the appropriate step pay rate within their classification's pay range based on completed years in their current class series as of June 30. All current and former State employees must ensure that your entire work history within the State Classified System, including at Institutions of Higher Education, is indicated in your application so that your time-in-series can be calculated accurately. Please verify that this information is included in your application in the supplemental questions. + Yes + No 04 Are you willing to accept an offer in 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 What past professional experiences prepared you for this position? 07 What qualities have made you successful in your professional career? 08 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 Employer 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