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Eligibility Operations Data Analyst
  • Database
  • Data Mining
State of Colorado Job Opportunities
Denver, CO 80203
140 days ago
Department Information







Medicaid Operations Office
Must be a Colorado resident to apply!

Make a difference-Join HCPF by improving health care access and outcomes for the people we serve while demonstrating stewardship of financial resources.
Information about the Department:

THIS ANNOUNCEMENT WILL REMAIN OPEN UNTIL ADVERTISED OR UNTIL 40 APPLICATIONS ARE RECEIVED, WHICHEVER OCCURS FIRST. YOU ARE ENCOURAGED TO APPLY EARLY.

The Department of Health Care Policy and Financing (Department) offers a competitive benefits package to include the Public Employees Retirement Account (PERA), 401k/457, health/dental insurance options, 10 holidays, accrual of paid sick and vacation/annual time, flex place and flex time. The Department is also centrally located; offers affordable ECO passes; has a fitness center on-site; and a variety of discounts on services and products are available to state employees through the State of Colorado's Work-Life Employment Discount Program. The Department also encourages employees to take advantage of advanced education and offers reduced college tuition through CSU Global for their employees. This Department is a "Tobacco Free Workplace". www.colorado.gov/hcpf

The Medicaid Operations Office oversees health plan operations administered by the Department. This office is responsible for the overall operations of Medicaid, including Child Health Plan Plus (CHP+). This office manages the daily operations of Medicaid to ensure compliance with Federal and State laws, rules and regulations. In addition, this office is responsible for establishing and monitoring the operational performance standards (e.g., call center performance standards, claims payment standards, enrollment processing standard, etc.) for contractors working for the Department. This office establishes systems for robust monitoring of health plan operations, oversees the collection of information necessary for performance monitoring and directs staff reviews to identify and mitigate compliance risks. This office has oversight of claims payment operations, the member and provider call centers; the member identification card contractor; eligibility determinations made by eligibility sites and monitoring of county partners; critical compliance to include fraud, waste, and abuse and program integrity.

Description of Job

This position exists within the Performance Improvement Team of the Medicaid Operations Office. Position develops new standardized procedures for the Performance Improvement Team, participates in efforts to develop and document best practices, and design new performance measure reporting processes. Position develops and completes a range of statistical and data analyses of eligibility data in the main data warehouse to support the Division's data mining functions of identifying root causes of backlog, untimely processing, and accuracy errors. Position uses database software made available by the Department and descriptive statistical techniques to extract, manage, analyze, and summarize Medicaid eligibility and enrollment data and other data that may be available. This position makes inferential statistical analyses based on small samples (for example: accuracy and audit data) while also developing performance control charts for analysis of entire samples of data (for example: timeliness and backlog data). Position develops and completes a range of analyses and reports using software provided by the Department employing various techniques, including statistical software, data analytics, algorithm development, data matching, and regression analysis. Understands and interprets written materials, including technical materials, rules, regulations, reports, charts, graphs, or tables. The position also evaluates alternative methods to detect eligibility errors, untimely determinations, waste and abuse of Medicaid dollars and program revisions to improve eligibility monitoring. Position conducts assigned, routine, and monthly data compilation and analysis projects as well as formulating original quarterly projects to monitor eligibility Policy compliance with Medicaid statutes and regulations. Documents all analyses in the format required by Section standard operating procedure. Position provides data analytical support to the Eligibility Division. Position collaborates with others and works with teams to accomplish Eligibility Performance Improvement Team goals. The work of this position is to provide support and focus to Eligibility Site Accountability. The position helps to inform and provide data to Eligibility Site Scorecards.

Position serves as a direct resource for responding to questions and identifying trends as they relate to timeliness, accuracy, or any other reported eligibility data. Position monitors, analyzes, and summarizes findings of specific Cognos reports as it relates to eligibility issues such as timeliness, backlog, redeterminations, mass update exception reports, pending reports, and court reports within the Medical eligibility sites. Position researches and generates awareness to Performance Improvement about new technologies and system changes that impact eligibility determination timeliness, accuracy, and business processes, providing statewide eligibility site workers with tools/best practices to improve timeliness and business processes for enrollment and eligibility determinations for Medical Assistance programs.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

MINIMUM QUALIFICATIONS:

Education and Experience:

Bachelor's degree from an accredited institution in a field of study related to the work assignment AND two years of professional experience in an occupational field related to the work assigned to the position.

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, one or two years of general experience respectively.

Preferred Qualifications:

  • Knowledge of how to gather and document business requirements and use cases;
  • Knowledge of how to gather and analyze data and produce reports based on the findings;
  • Creativity and innovation including the ability to come up with unusual or clever ideas about a given topic or situation, or to develop creative ways to present materials;
  • Ability to set and prioritize workload, develop a work plan with tasks, time frames, milestones, resources, and dependencies;
  • Strong communication skills, verbal and written
  • Ability to be self-motivated and self-directed, while possessing the ability to work in a team environment.
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 disciplinarily 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 the position, you may protest the action by filing an appeal with the State Personnel Board/State Personnel Director within 10 days from the date you receive notice of the elimination.

Also, if you wish to challenge the selection and comparative analysis process, you may file an appeal with the State Personnel Board/State Personnel Director within 10 days from the receipt of notice or knowledge of the action you are challenging.

Refer to Chapters 4 and 8 of the State Personnel Board Rules and Personnel Director's Administrative Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel Director's Administrative Procedures are available at www.colorado.gov/spb.

A standard appeal form is available at: www.colorado.gov/spb. If you appeal, your appeal must be submitted in writing on the official appeal form, signed by you or your representative, and received at the following address within 10 days of your receipt of notice or knowledge of the action: Colorado State Personnel Board/State Personnel Director, Attn: Appeals Processing, 1525 Sherman Street, 4th Floor, Denver, CO 80203. Fax: 303-866-5038. Phone: 303-866-3300. The ten-day deadline and these appeal procedures also apply to all charges of discrimination.

Supplemental Information

How to Apply (PLEASE READ CAREFULLY)

Applicants are encouraged to attach a cover letter and resume to their application.

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 of 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 up to 6 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 and information by the closing date of this announcement will result in your application being rejected.

~THE STATE OF COLORADO IS AN EQUAL OPPORTUNITY EMPLOYER~

ADAAA Accommodations: Any person with a disability as defined by the ADA Amendments Act of 2008 (ADAAA) may be provided a reasonable accommodation upon request to enable the person to complete an employment assessment. To request an accommodation, please contact by phone or email at least five business days before the assessment date to allow us to evaluate your request and prepare for the accommodation. You may be asked to provide additional information, including medical documentation, regarding functional limitations and type of accommodation needed. Please ensure that you have this information available well in advance of the assessment date.

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 Healthcare Policy and 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 303-866-3887.

Technical Help
If you experience difficulty in uploading or attaching documents to your online application, call NEOGOV technical support at 877-204-4442 anytime between 6:00 a.m.-6:00 p.m. (Pacific Time).

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