Eligibility Operations Manager
Full Time
Denver, CO 80203
Posted
Job description
Department Information
STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION
NOTE: This announcement may be used to fill multiple openings.
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 an Eligibility Operations Manager to join our Eligibility Operations Unit within the Medicaid Operations Office!
The Eligibility Operations Section has four work areas responsible for supporting operations at all Eligibility Sites (Counties, Medical Assistance Sites, and Eligibility Application Partners). This is done by improving performance through identifying gaps in performance standards, supporting, implementing, and operationalizing eligibility projects, monitoring eligibility site performance, and providing technical support and guidance for proper administration and determination of Medical Assistance (MA) eligibility.
The Eligibility Operations Section includes the following work areas:
- Compliance: Compliance Specialists are responsible for identifying Eligibility Sites’ compliance with administrative and eligibility processes.
- Continuous Improvement: Continuous Improvement Specialists are responsible for the design, development, and implementation of a variety of online and in-person Continuous Improvement Learning Sessions.
- Performance Measurement: Performance Measurement is responsible for performance measures in all MAP dashboards as well as identifying other means of measuring performance and effectiveness.
- Eligibility Site Communications: The Med Eligibility Inbox focuses on providing answers to MA eligibility questions that come in from Eligibility Sites and other stakeholders.
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PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans
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Medical, Dental, and Vision insurance coverage
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Automatic Short-Term and Optional Long-Term Disability Coverage
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Life and AD&D Insurance
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Flexible Spending Accounts (FSAs)
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Family Medical Leave Act (FMLA) job protection and State of Colorado Paid Family Medical Leave (PFML)
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11 Paid Holidays Annually and Accrued Annual and Sick Leave
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Accrued Sick Leave for State of Colorado Temporary Employees
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Flexplace and Flextime work arrangements
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Variety of discounts on services and products available through the State of Colorado's Work-Life Employment Discount Program
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Free RTD EcoPass to all eligible State Employees
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Credit Union of Colorado Membership Eligibility
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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
As the Eligibility Operations Manager within the Eligibility Division, this position assigns the resources allocated to the work unit in a manner that meets state and federal mandates. This purpose is accomplished through personnel management, oversight of day-to-day operations, work planning and implementation, interaction with legislative and budget cycles on eligibility issues, and management reporting.
Duties include, but are not limited to:
- Providing Department management with regular updates on eligibility issues and explaining their impact on clients and the Department's budget.
- Acting as a direct representative of the Department at internal and external planning sessions, committees and other communications with partners and stakeholders regarding eligibility operations, performance monitoring, and quality efforts, among other topics and projects.
- Overseeing operations and program management of the performance monitoring, quality, continuous improvement, and compliance efforts regarding the Medical Assistance Programs eligibility sites and contracted vendors.
- Developing, implementing, and managing budgets and project plans, identifying and incorporating timelines and tasks for streamlined operational processes, performance management, training, communications, and procedures at eligibility sites to ensure projects and programmatic initiatives meet the Department’s goals in collaboration with the Eligibility Division’s Section Managers.
- Developing and maintaining productive working relationships with state departments to promote consistency in eligibility site processes and strengthen program integrity.
- Supervising section staff with direct oversight, authority, and program management for all aspects of the Eligibility Operations Section.
- Providing direction, leadership and performing all of the day-to-day supervisory tasks, including hiring, conducting performance evaluations, administering performance correction actions and resolving informal grievances.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
Education and Experience:
Nine years of professional experience with Medicaid and CHP+ operational processes, to include and business process/continuous improvement experience, and at least one year as a supervisor or manager.
OR
Bachelor's degree from an accredited institution in a field of study related to the work assignment AND Five years of professional experience with Medicaid and CHP+ operational processes, to include and business process/continuous improvement experience, and at least one year as a supervisor or manager.
Substitutions:
Additional appropriate education will substitute for the required experience on a year-for-year basis.
PREFERRED QUALIFICATIONS
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Prior state experience related to the duties of this position
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Experience working in Medical Assistance Eligibility
- Experience working with CBMS
- Experience working in project management.
- Familiarity with LeanSixSigma methodology
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
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All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.
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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.
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Position is required to travel to state-wide locations for MA Site visits and oversight, trainings and MA Site related meetings/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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