Care Manager Job at State of Colorado Job Opportunities
State of Colorado Job Opportunities Colorado
$53,484 - $78,276 a year
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:
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PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans
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Medical, Dental, and Vision insurance coverage
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Automatic Short-Term and Optional Long-Term Disability Coverage
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Life and AD&D Insurance
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Flexible Spending Accounts (FSAs)
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Family Medical Leave Act (FMLA) job protection and State of Colorado Paid Family Medical Leave (PFML)
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11 Paid Holidays Annually and Accrued Annual and Sick Leave
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Accrued Sick Leave for State of Colorado Temporary Employees
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Flexplace and Flextime work arrangements
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Variety of discounts on services and products available through the State of Colorado's Work-Life Employment Discount Program
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Free RTD EcoPass to all eligible State Employees
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Credit Union of Colorado Membership Eligibility
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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
The Managed Care Rates and Financial Review Division develops rate-setting methodology and implements the rates for the Department’s managed care entities, including: Health Maintenance Organizations (HMO), Program for All Inclusive Care for the Elderly (PACE), Children Health Plan Plus (CHP+), and Regional Accountable Entity (RAE) Behavioral Health (BH). Rate development must comply with all applicable state statutes, federal regulations and actuarial standards of practice. The Managed Care Rates Section utilizes many data sources in order to develop provider rates, such as claims and eligibility data, provider encounter data, cost reports, and Medicare rate information. Section evaluates, validates, and reconciles claims and eligibility data for the purposes of rate development. In addition, the Managed Care Rates Section utilizes its technical expertise to evaluate data elements and methods for payment reform efforts such as Accountable Care Collaborative. This section plays an important role toward the Department’s mission to improve access to cost-effective, quality health care services.
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.
Description of Job
The Finance Office welcomes your interest in the Finance Managed Care Rate & Reconciliation Analyst position. This position works closely with supervisors and others and is in training.
Responsibilities in this position include:
Use database software to extract, compile, and interpret data.-
Develop and complete a range of analyses and reports using statistical measures.
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Understand and interpret written material, including technical materials, rules, regulations, reports, charts, graphs, or tables. Using transaction record analysis, including SQL based database extracts and statistical techniques, position produces summarized reports.
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Document all analysis in format required by Section standard operating procedure.
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Collaborate with others or works on teams to accomplish work-related activities.
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Communicate results, problems, plans suggestions, or conditions with others.
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Notify individuals in writing or verbally of decisions, problems, or further actions required. Explain technical information in writing and/or verbally.
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Perform quality reviews and provides statistical analysis support for all the programs.
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Research eligibility information which forms the basis for identifying actuarially equivalent populations.
Review financial data submitted by the managed care entities, determines its validity and correctness, and makes recommendations regarding any necessary wrap-around payments and capitation reconciliations.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
Experience Only:
Five years of experience in Data analysis, Data manipulation, or a closely related field
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Bachelor’s Degree in Economics, Mathematics, Statistics, Data Science, Finance, Public Health, or closely related field
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One year of experience in Data analysis, Data manipulation, or a closely related field
PREFERRED QUALIFICATIONS
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Prior state experience related to the duties of this position
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Master’s degree in Economics, Data Science, Mathematics, Finance, Public Health
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SQL or other database experience
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Intermediate to expert level in Excel
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Experience in Tableau, SAS, or other statistical and visualization packages
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Experience interpreting federal and state rules, regulations, laws
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Managed Care experience
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Professional experience with research and data analysis
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Professional experience working with large complex data sets
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Professional experience with SharePoint, Microsoft Office
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Strong attention to detail
Substitutions:
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Additional appropriate education will substitute for the required experience on a year-for-year basis.
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Additional appropriate experience will substitute for the degree requirement on a year-for-year basis.
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
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All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.
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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 06/30/2024. Successful candidates will sign a Waiver of 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.
Supplemental Information
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 Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.
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