Care and Case Management Operations Analyst

Care and Case Management Operations Analyst Print (http://agency.governmentjobs.com/colorado/jobbulletin.cfm?jobID=3234109&sharedWindow=0) Apply Care and Case Management Operations Analyst Salary $4,370.00 - $5,209.00 MonthlyLocation Denver Metro, COJob TypeFull TimeDepartmentDepartment of Health Care Policy and FinancingJob NumberUHA05566-9-2021Closing9/26/2021 11:59 PM Mountain Description

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Department InformationSTATE OF COLORADO RESIDENCY REQUIRED NOTE: This announcement may be used to fill multiple openings. Position is term-limited with funding through June 30, 2022 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 Care and Case Management Operations Analyst to join our Operations & Administration Division in the Office of Community Living ! 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 (https://stateofcoloradobenefits.com/index.php/portfolio-item/overview/) , Dental (https://stateofcoloradobenefits.com/index.php/portfolio-item/dental/) , and Vision (https://stateofcoloradobenefits.com/index.php/portfolio-item/vision/) insurance coverage

Automatic Short-Term and Optional Long-Term Disability Coverage (https://stateofcoloradobenefits.com/index.php/portfolio-item/disabilityinsurance/)

Life and AD&D Insurance

Flexible Spending Accounts (https://stateofcoloradobenefits.com/index.php/portfolio-item/flexible-spending-account/) (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)

10 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

Discounted RTD EcoPass (https://www.rtd-denver.com/fares-passes/ecopass)

Reduced college tuition through CSU Global (https://csuglobal.edu/cost/tuition-discounts/employer-partners/state-colorado)

Credit Union of Colorado Membership Eligibility

The ongoing COVID-19 pandemic has impacted how and where we do our work. We currently work remotely but in the future, we anticipate this position will work from the office on certain days, possibly full-time, or as part of a hybrid model with in-office and remote work.

The Operations and Administration Division (Division) within the Office of Community Living (Office) acts as the service and support entity of the Office. The Division includes financial oversight, contract management, administrative support, and systems support for the day-to-day activities of the Office. The Finance Section within the Operations and Administration Division consists of various program areas: budget, finance, financial data analysis, financial compliance, contractual oversight, contractual compliance, operational support, and evaluation. These program area duties include: financial management of over 150 contracts annually for the Office; management and processing of all invoices for contracts and purchase orders for the Office; managing financial data in various information systems; directing and managing contract process changes; developing budget requests; managing and allocating newly appropriated community funding; management of twenty (20) Community Centered Board (CCB) contracts and budgets totaling approximately $25 million annually; management of twenty-four (24) Single Entry Point (SEP) contracts and budgets totaling approximately $38 million annually; financial and contractual reviews of the 20 CCBs to include the Family Support Services Program, State Supported Living Services Program, and OBRA Specialized Services Program; subrecipient monitoring activities for 20 CCBs and 24 SEPs.The Systems Unit exists to provide technical and operational support to staff within the Office to meet the business goals of the Office and ensure compliance with federal requirements. Work includes drafting high level business requirements for systems implementations and changes used by case managers and LTSS providers: the Department’s Medicaid Management Information System (MMIS), its Prior Authorization entry subsystem, and the electronic data warehouse. Staff research and resolve claims issues, assist with data management, and support decision making through data analytics. The Unit leads all of the Office’s systems changes to the interChange and Bridge. Systems Unit Staff work with Office policy SMEs to ensure provider enrollment and revalidation requirements are accurate, updated, and align with 1915(c) waiver and other regulatory requirement; communicate with providers and MMIS vendor regarding escalated enrollment and revalidation applications; and oversee MMIS vendor compliance with all HCBS provider specialty enrollment requirements.Description of JobWhat you'll be doing:The Benefits Utilization System (BUS) is an online database provided by the Department to Case Management Agencies (CMAs) and contractors for documenting client assessments, service plans, and other information crucial to monitoring and compliance for Medicaid Long Term Services and Supports. The BUS will be replaced by the new care and case management (CCM) system. through work directly related to the testing and implementation of this Information Technology (IT) system. Primary, mission-critical work of this term-limited role extends to the following responsibilities:Uploading CCM test results from Office testers to the Application Lifecyle Management (ALM) for escalation and review by the Department’s Fiscal Agent and the CCM Tool vendor.

Execute testing and communication plans based on business process analysis and direction from management.

As directed by management, write and review defect descriptions regarding the CCM tool.

Writing and editing test scenarios as assigned by management.

Execute User Acceptance Testing (UAT) for the various phases of the CCM tool.

Support operational workarounds and additional tasks as assigned related to the phases of the CCM implementation.

Support Business Process Re-engineering work as assigned to ensure Case Management Agencies are kept informed of the impacts to their daily business.

Support post-implementation activities, including case manager support and training as needed.

Managing all BUS, Bridge, and CCM access processes across all case management agencies and other system users.

Reset passwords as requested by end users.

Coordinate BUS-related member data clean up with the Governor’s Office of Information Technology

Provide guidance to BUS end-users regarding the resolution of problems or issues with the BUS.

This position will be needed through June 30, 2022, the date by which the Department anticipates the CCM to be implemented. Once implemented, the CCM tool becomes the system of record for case management, thus replacing the BUS. Position 4289 will perform all support functions to the CCM tool, once it is implemented.Minimum Qualifications, Substitutions, Conditions of Employment & Appeal RightsMINIMUM QUALIFICATIONS:Education and Experience:Bachelor’s Degree in Computer Science, Business Information Systems, Information Technology, Human Services, or related field AND two years of professional experience working with either the ongoing management of a large health care IT system or two years of experience working as a case manager in a Medicaid context requiring extensive knowledge of a Case Management IT system. Substitutions:A combination of work experience in the occupational field or specialized subject area of the work assigned to the job, which provided the same kind, amount, and level of knowledge acquired in the required education, may be substituted on a year-for-year basis for the bachelor's degree. A master's or doctorate degree from an accredited college or university in a field of study related to the work assignment may be substituted for the bachelor's degree and at the agency's discretion, one or two years of general experience respectively. Preferred Qualifications:Experience testing a care or case management system.

Experience working with large health care IT systems, and/or experience working for a healthcare payer, provider, or case management agency.

Experience with e-health initiatives and projects.

Business Analysis in a fast-paced IT environment.

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.

Effective September 20, 2021 , employees will be required to attest to and verify that they are fully vaccinated for COVID-19, or, submit to twice-weekly serial testing. Upon hire, new employees will have three (3) business days to provide attestation to their status with proof of vaccination, or begin twice-weekly serial testing for COVID-19.

Testing place is to be determined and will be considered paid work time.

Note: Fully Vaccinated means two (2) weeks after a second dose in a two-dose series of the COVID-19 vaccine, such as the Pfizer or Moderna vaccine, or two (2) weeks after the single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine, as defined by the State of Colorado’s Public Health Order (https://drive.google.com/file/d/1b3w36DgcK8pNlPz0DVibaUhhDcb-YyJH/view) a nd guidance issued by the Colorado Department of Public Health & Environment.

This is a term-limited position with funding through June 30, 2022. 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 (dpastate.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 InformationHow 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, Debra Becerra, at debra.becerra@state.co.us or call 303-866-4438. The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.