Program Operations Specialist

Full Job Description

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.

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:

• PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans

• Medical, Dental, and Vision insurance coverage

• Automatic Short-Term and Optional Long-Term Disability Coverage

• Life and AD&D Insurance

• Flexible Spending Accounts (FSAs)

• 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

• 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 to all eligible State Employees

• Reduced college tuition through CSU Global

• 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 Program Operations Specialist for the ACC/Delivery Systems Division of the Cost Control & Quality Improvement Office (CCQI)!

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.**

Requirements

WHAT YOU'LL BE DOING AS PROGRAM OPERATIONS SPECIALIST:

• Responsible for eConsult contract administration and the recognized Department point of contact on the eConsult program.

• Provides administrative support and consultation to leadership on the eConsult platform, specifically related to the platform’s purpose of increasing access to specialty care for Health First Colorado members and decreasing costs for the delivery of care.

• Oversees implementation of a fully operational Medicaid eConsult program and ongoing maintenance and operation of the program.

• Reviews and approves contractor deliverables and ensures compliance with Department policies and processes, federal regulations and program rules.

• Determines when a contract amendment is necessary for the eConsult contract and oversees the contract amendment process, working with Purchasing & Contracts and other teams within the Department to implement needed changes on a timely basis.

• Organizes and designs communications and stakeholder engagement regarding the eConsult program to prepare providers and support their onboarding and utilization of the eConsult system.

• Solicits and analyzes input on proposed program modifications.

• Tracks and assesses performance and compliance of the RAEs, tracking and reviewing RAE deliverables.

• Works with DSPI and other Department sections to implement the ACC.

• Collaborates with ACC program specialists to ensure RAE performance.

• Improves alignment between the ACC and all other HCPF administered programs as well as external payers.

• Bridges policy and program design with operations.

• Troubleshoots technical operations issues related to contract monitoring and oversight.

• Assists in the implementation of quality control processes around work products developed in areas related to member and provider enrollment, attribution, and payment.

• Oversees project management tasks, including conducting research and handling various activities related to the ACC program.

• Develops timelines and uses other project management tools to ensure project deadlines are met and to ensure alignment across the ACC program.

• Ensures that reports and special projects, such as fiscal note reviews, ad hoc requests for information from managers or stakeholders, requests from other states, legislative reports, are completed in a timely and comprehensive manner.

Qualifications

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:

CONTRACT ADMINISTRATOR III

MINIMUM QUALIFICATIONS:

There are two ways to qualify for this position:

Option 1:

Experience Only:

Six (6) total years of professional experience in managing contracts, policy development and/or implementation, or related work in support of health plan operations.

Option 2:

Education and Experience:

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

AND

Two (2) total years of professional experience in managing contracts, policy development and/or implementation, or related work in support of health plan operations.

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 the Job 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

• Masters degree in Public Administration, Health Sciences, Business Administration, Health Administration

• Experience working in Medicaid or Managed Care

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.

Additional 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, Anupreet Kaur, at anupreet.kaur@state.co.us.

The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.