Colorado Medicaid Enterprise Solutions (CMES) Integration Business Analyst

State of Colorado
Statewide, CO


STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION

Note: This announcement may be used to fill multiple openings.


Envision Yourself Working at HCPF


The State of Colorado strives to create a Colorado for All by building and maintaining workplaces that value and respect all Coloradans through a commitment to equal opportunity and hiring based on merit and fitness. The State is resolute in non-discriminatory practices in everything we do, including hiring, employment, and advancement opportunities.


TheDepartment of Health Care Policy & Financing (HCPF)oversees and operatesHealth 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 looking for aColorado Medicaid Enterprise Solutions (CMES) Integration Business Analystfor theBusiness Solutions Division (BSD)of theHealth Information Office (HIO)!


The BSD within HIO manages and enhances computerized claims processing and information management systems that support the Department’s compliant administration of the state’s medical assistance programs including Health First Colorado and Child Health Plan Plus (CHP+). The work unit supports multiple state agencies that utilize CMES services including the Colorado Department of Human Services (CDHS) and the Behavioral Health Administration (BHA). In order to minimize the disruption of services and operations, the work unit balances business needs with the need to deliver a compliant system that adheres to the Department’s data governance policies and the security standards of the Governor’s Office of Information Technology (OIT).


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 acompetitive benefits package:


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.**


What You’ll Be Doing as CMES Integration Business Analyst:

  • Document and manage requirements for enhancements related to the integration of CMES modules including but not limited to the Enterprise Data Warehouse (EDW), Program Integrity (PI), Recoveries Database (RED), and Patient Access and Interoperability (PAI).

  • Analyze and validate data and interface transmission for the Medicaid Enterprise Solution (MES) to ensure system processes are aligned with the Medicaid & CHP+ regulatory and programmatic rules.

  • Subject matter expert in the technical aspects of Decision Support Systems portfolio modules including claims, eligibility and enrollment data, financial payment data, provider enrollment data, third party liability data.

  • Communicate system strategies with various operations, financial, policy, program and technical staff.

  • Research the system functions to discover information, expose and resolve problems, identify workarounds, and evaluate the sustainability and configurability of system change across the CMES.

  • Ensure system change is documented and traceable from scope and requirements, to testing and implementation.

  • Identifies and recommends potential operational and systematic alternatives or “workarounds” for features that are not functioning as expected or able to be delivered on time.

  • Analyze CMES data quality by researching and reviewing data models, data dictionaries, interface control documents, interface transactions, reports and files and by ensuring all documentation and data is kept up to date and in compliance with ESI standards.

  • Research, develop, and analyze data queries in the ESI Operational Data Store or other sources, and for reporting and communicating the results to Department Staff.

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



Minimum Qualifications:

There are two ways to qualify for this position:


Option 1:

Experience Only:


Six(6) total years of professional experience in:

  • Medicaid or CHP Operations;

  • Health Care systems development;

  • Health Care Project Management;

  • Health Care Business Analysis; or

  • A closely related occupational field.


Option 2:

Education and Experience:


Bachelor's degree from an accredited institution in Policy Administration, Health Care Policy, Business Administration, or a field of study related to the work assignment


AND


Two(2) total years of professional experience in:

  • Medicaid or CHP Operations;

  • Health Care systems development;

  • Health Care Project Management;

  • Health Care Business Analysis; or

  • A closely related occupational 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


Note: Per theJob Application Fairness Act,you may redact information that identifies your age, date of birth, or dates of attendance at or graduation from an educational institution on your transcripts.


Preferred Qualifications

  • Previous relevant professional state experience

  • Certification in Business Analysis (CBAP or CPOA) or Certification in Project Management (PMP or PgMP)

  • Data Query, Data Analytics, Data Governance, or Data Presentation experience


Skills to Support Success

  • Ability to translate health care policy into business requirements

  • Commitment to integrity and meeting deadlines

  • Ability to work in a team environment remotely and in-person developing relationships across an organization that promote innovation and collaboration

  • Flexible, must be able to lead meetings and take direction at the same time

  • Ability to communicate technical details to a non-technical audience


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 tospb.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, atspb.colorado.govunder 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 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, Anupreet Kaur, atanupreet.kaur@state.co.us.


The Department of Health Care Policy & Financingdoes notoffer sponsored visas for employment purposes.

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