Department Information
STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION
NOTE: This announcement may be used to fill multiple openings.
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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 Long Term Care Policy Specialist to join our Eligibility Policy Unit within the Medicaid Operations Office!
The Eligibility Division Policy Section, located in the Medicaid Operations office (MOO), is responsible for policy regarding a member’s eligibility for Medical Assistance Programs. This includes interpreting state and federal regulations concerning eligibility across a number of categorical assistance programs, ensuring compliance with state and federal regulations and laws, and enrolling members onto Medical Assistance Programs through the application process and Colorado Benefits Management System (CBMS). This is accomplished through research, analysis, written and verbal communication with Medicaid members, eligibility workers, and high-level program groups, and formal training for field agents (i.e., county departments of social/human services, options for long-term care, medical assistance sites). This work unit implements rule changes concerning medical eligibility policy and practices. This work unit is responsible for coordinating system changes with the Eligibility Systems Section. Further, the unit is responsible for implementing the eligibility policy of Medical Assistance programs, including: Adult Medicaid, Medicare Savings Programs (MSP), Low Income Subsidy (LIS), Long Term Care (LTC), Home and Community Based Services Waivers (HCBS), and MAGI programs (Parents, Pregnant Women, Adults, and Children).
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
- 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
This position can work fully remotely from anywhere in the State of Colorado.
**Please note - equipment provisioning and certain onboarding tasks will take place in person, in our downtown Denver office, on the first day of employment.**
Description of Job
The purpose of this position is to direct, decide upon, and implement eligibility policy specific to Long Term Care (LTC). Position is the key decision maker for the Department regarding Long Term Care policy and relied upon for critical decisions.
Duties include, but are not limited to:
Directing, deciding upon, and implementing eligibility policy specific to Long Term Care (LTC).- Directing offices outside of the Department, such as the Governor’s Office, towards implementation of long-term goals for Long Term Care Medicaid including presumptive eligibility or elimination of the asset test.
- Serving as a resource to the program leads and management for the eligibility policy section regarding the implementation of eligibility policy specific to LTC.
- Directing the Department’s management, the Department’s sister agencies such as CDHS and other external partners and stakeholders through workgroups, steering committees and other internal and external meetings towards new LTC Medicaid eligibility policies and rule changes.
- Designing strategy, processes, guidelines, rules, and standards that have a direct impact on client eligibility requirements and LTC program benefits.
- Directing management and policy to increase effectiveness or to ensure compliance.
- Directing communications about program changes that impact eligibility site partners.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
Education and Experience:
Bachelor's degree from an accredited institution in a field of study related to the work assignment.
AND
Four years of professional experience determining eligibility Long Term Care and/or Medicaid Assistance at an eligibility site or Department of Human Services.
Substitutions:
Additional appropriate experience will substitute for the degree requirement on a year-for-year basis.
Additional appropriate education will substitute for the required experience on a year-for-year basis.
PREFERRED QUALIFICATIONS
- Prior state experience related to the duties of this position
- Experience with program development involving complex problem resolution
- Experience with researching and applying eligibility policy and/or experience interpreting Medicaid federal and state regulations and laws
HIGHLY DESIRABLE KNOWLEDGE, SKILLS, & ABILITIES
- 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
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.
- This position may be required on occasion to travel to Colorado counties or conferences.
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.
Supplemental 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, Virginia Miller, at virginia.miller@state.co.us.
The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.
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