Rate Review Analyst

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 Rate Review Analyst Analyst for the Rates Review and research Unit!

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

Brief description of the Finance Office:

The Finance Office consists of the Chief Financial Officer, the Budget Division, Controller Division, Managed Care and Payment Reform Division, Fee for Service Division, Special Financing Division, Audits Division and Procurement Division.

The Chief Financial Officer (CFO) is accountable for the financial and risk management operations of the Department, and oversees control systems that report financial results and maintain Department compliance.

The CFO is responsible for the Department's financial data and reporting, and its use of data analytics to define value and measure quality with regard to Department operations.

The CFO develops the Department's financial and operational strategy, and generates actionable analytics tied to that strategy.

Brief description of the work unit:

The Rates Review and Research section exists to fulfill the requirements of CRS 25.5-4-401.5 by quantitatively evaluating, assessing, and reporting on the sufficiency of fee-for-service provider reimbursement rates to ensure adequate access to services is available in compliance with the Medicaid equal access provision contained in 42 U.S.C.

§1396a(a)(30)(A), and associated sub-regulatory guidance contained in 42 CFR Part 447.

Additionally, this work unit exists to measure the impacts of current reimbursement policies and methodologies and estimate the impact of potential change.

Rate development must comply with all applicable state statutes, federal regulations, and actuarial standards of practice.

The Rates Review and Research section utilizes many data sources in order to develop and evaluate provider rates, such as claims and eligibility data, provider encounter data, cost reports, and Medicare rate information.

The Rates Review and Research Section plays an important role in working toward the Department’s mission to improve access to cost-effective, quality health care services for Coloradans.

Key responsibilities:

This position exists to analyze and interpret financial, utilization, and other data, including, but not limited to administrative claims data, survey data, geographic information, and other publicly available information to assess client access to, and provider supply of, care across the spectrum of Health First Colorado covered services in support of the work of the Medicaid Provider Rate Review Advisory Committee (MPRRAC) created by SB15-228 and SB22-236 respectively.

This position exists to assist in analyzing cost, utilization, and other data including, but not limited to, administrative claims data, survey data, cost information, and/or data from the Colorado All Payer Claims Database (APCD), to determine how Colorado Medicaid rates compare to those of other payers, including other state Medicaid agencies, Medicare, and commercial carriers; projecting budget impacts of changes in provider reimbursement levels and/or methodologies; and generating summary rate setting data.

This position collaborates extensively with internal and external stakeholders and subject matter experts, and frequently functions as part of a multi-disciplinary team.

Additionally, the position exists to collaborate with the Department’s contracted actuaries in rate comparison and utilization analyses and plays a key role in producing annual reports for the Medicaid Provider Rate Review Advisory Committee (MPRRAC), the Joint Budget Committee (JBC), and state legislature.

This position extensively utilizes SQL, in addition to several software packages including Tableau, TOAD for Data Analysts, ArcGIS and Microsoft Excel, to perform quantitative analysis and develop data visualization materials.

This position collaborates extensively with internal and external stakeholders and subject matter experts, and frequently functions as part of a multi-disciplinary team.

Additionally, the position exists to collaborate with the Department’s contracted actuaries in rate comparison and utilization analyses and plays a key role in producing annual reports for the MPRRAC, the Joint Budget Committee, and state legislature.

Qualifications

Residency Requirement:

This posting is only open to residents of the State of Colorado at the time of submitting your application.

Minimum Qualifications

Rate or Financial Analyst I H8G2XX

There are two ways to qualify for this position:

Option 1:

Experience Only:

Five (5) total years of specialized experience in collecting, analyzing, and interpreting financial data including administrative claims, survey data, and geographic data.

Option 2:

Education and Experience:

Bachelor's degree from an accredited institution in Health Care Administration, Business Administration, Accounting, Statistics, Economics, or a related field

AND

One (1) total years of professional experience in collecting, analyzing, and interpreting financial data including administrative claims, survey data, and geographic data.

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

• Master’s degree

• SQL or other database experience

• Intermediate to expert level in Excel

• Experience in Tableau, SPSS, SAS, R, or other statistical and visualization packages

• Experience in quantitative or qualitative research

• Experience in academic, government or formal report writing

• Prior state experience related to the duties of this position

Skills to Support Success

• Ability to translate health care policy into business requirements

• Commitment to keeping promises and meeting deadlines

• 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 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.