Colorado State Long Term Care Policy Specialist in Denver Metro, Colorado
Long Term Care Policy Specialist
Long Term Care Policy Specialist
Denver Metro, CO
Department of Health Care Policy and Financing
12/17/2018 11:59 PM Mountain
Health Information Office
Make a difference-Join HCPF by improving health care access and outcomes for the people we serve while demonstrating stewardship of financial resources.
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".http://www.colorado.gov/hcpf.
The Health Information Office develops, implements, and maintains the Department's Health Information Technology (Health IT) and related Information Technology (IT) infrastructure, while coordinating with the Governor's Office of Information Technology and other stakeholders on HIT and IT projects that impact the Department. Major responsibilities of the Health Information Office include enhancing and maintaining the Department's health care claims payment system (Medicaid Management Information System or MMIS) and client eligibility system (Colorado Benefits Management System or CBMS) by developing requirements documentation, reviewing detailed system design approaches, proposing systems solutions to program staff and implementing systems solutions to support Department initiatives. In addition to aligning the Department's infrastructure, this Office creates a foundation for emerging Health IT solutions that will be necessary to implement the Department's transformational vision for the future of Medicaid.
Within the Office, the Eligibility Division is comprised of the Eligibility Policy Section, the Eligibility Contracts and Site Relations Section, and the Administrative Unit. The Division is responsible for policy, contract management and communications related to Medicaid and CHP+ eligibility. The Division interprets and communicates new and existing Medicaid/CHP+ law to define eligibility requirements for Coloradans, and oversees the site agreements, contracts, and regulations involved in client qualifications for Medicaid and CHP+. In addition, the Division serves as the primary contact for stakeholders concerning eligibility, including the Connect for Health Colorado Marketplace, Governor's Office of Information Technology, Centers for Medicare and Medicaid Services, and advocates.
Description of Job
Long-Term Care (LTC) services are provided to applicants/members who are in a Long-Term Care medical institution or in the community through Home and Community Based Services (HCBS) or the Program of All Inclusive Care for the Elderly (PACE). To be determined eligible and gain access to LTC services, a client must meet all eligibility criteria for the appropriate category of Medicaid.
This position is responsible for a strong working knowledge of the Long-Term Care Medical Assistance program and conducts research to support eligibility operational activities and initiatives. Position has a thorough understanding of the Medicaid federal regulations, interpreting the regulations, providing policy suggestions for state options, and facilitating and soliciting stakeholder input as needed. Position provides guidance and recommendations to increase effectiveness of current policy or to ensure compliance. This includes ensuring that program regulations comply with federal and state laws by writing new regulations or revising existing regulations. This position is responsible for understanding the relationship between the aged, blind, and disabled programs to other adult medical categories for overall program impact. The position conducts research and analyzes eligibility issues to clarify, assist, and resolve issues for counties, members, advocates and other stakeholders. Position serves as an official representative of the Department, regarding Medicaid eligibility related activities, to the Governor's Office of Information Technology (OIT), various contractors, and the Colorado Department of Human Services (CDHS) and all other partners and stakeholders. Position has responsibility for the administration, implementation, and oversight of all aspects of various policy for Medical Assistance. This position reviews, researches, and responds to appeals as they relate to the LTC population of disabled/aged members. This includes participating in appeals filed based on a denial and writing exceptions to Administrative Law Judge (ALJ) decisions, as appropriate. This position is responsible for communicating changes through formalized training, written materials and participating in conferences and workgroups.
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. Two years of professional experience with researching and applying Medicaid eligibility policy and/or experience interpreting Medicaid federal and state regulations and laws.
Additional appropriate experience will substitute for the degree requirement on a year-for-year basis. Additional appropriate education will substitute for required experience on a year-for-year basis.
DEFINITION OF PROFESSIONAL EXPERIENCE:
Work that involves exercising discretion, analytical skill, judgment, and 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.
Experience with program development involving complex problem resolution.
Prior experience working with diverse stakeholders or managing stakeholder relations.
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.
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.
Address Confidentiality Program:
If you are covered by the Address Confidentiality Program, CRS 24-21-201 through 24-21-214, please notify the HR office or analyst listed on this announcement so that you are provided the appropriate time extension for notifications provided by U.S. mail. The extension allowed under this program applies only to U.S. mail notifications that include a deadline of 10 days or less.
Applications will be reviewed to determine if you meet the minimum qualification for the position. If it is determined that you meet the minimum qualifications, your application will also be used as part of the comparative analysis process to identify a top group for further consideration. Be sure your application specifically addresses the requirements as listed in the minimum qualifications. Address your specialized experience, work products, and accomplishments as they relate to the position duties and minimum and preferred qualifications. Attach additional pages if necessary to fully explain your experience and accomplishments.
Failure to submit properly completed documents by the closing date of this announcement will result in your application being rejected.
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). Failure to submit properly completed documents by the closing date of this announcement will result in your application being rejected.
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