State of Colorado
Child & Maternal Health Systems Business Analyst
State of Colorado, Denver, Colorado, United States, 80285
Overview
JOB STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION. This announcement may be used to fill multiple openings. We are looking for a Child & Maternal Health Systems Business Analyst for the Systems Division of the Health Information Office (HIO) in the Department of Health Care Policy & Financing (HCPF). The Systems Division exists to manage and enhance computerized claims processing and information management systems for Medicaid, CHP+, and related programs, and to support audits, payments, and program management across MES and MMIS systems. This position can be fully remote from anywhere in Colorado; equipment provisioning and certain onboarding tasks will occur in person at our downtown Denver office on the first day of employment. Work location: remote within Colorado; first day onboarding in Denver Division: Systems Division, Health Information Office (HIO) Program scope: Medicaid, CHP+, and related state/federal programs
Key Responsibilities
Serve as the CMES Child and Maternal Health & Cover All Coloradans Staff Authority for the Department, overseeing system enhancement and operations related to this population. Document and enforce system policies and business rules to ensure member access to care and provider payment; ensure accurate reporting of payments. Lead interChange Payers to evaluate policies conflicting with CMS rules and ensure changes do not affect CMS certification or funding. Guide Medicaid/CHP+ program operations and finance teams to evaluate compliant options that meet program needs. Coordinate COB reporting and work with external and internal Payers to ensure accurate claims and encounters reporting. Manage CMES module integrations affecting member access, provider payments, or financial reporting; oversee enhancements impacting Health Plan Payers solutions. Provide management with decision support on system changes and policy alignment for Cover All Coloradans and Child & Maternal Health programs. Determine plan for elicitation and documentation of policies, rules, regulations, and business requirements to maintain accurate, timely, and compliant reporting of claims and COB/TPR data. Manage stakeholder and risk activities to obtain approval of business requirements from customers. Verify fiscal agent solutions meet program policies, rules, and business requirements. Communicate and determine test planning approaches for Health Plan System testing with stakeholders, vendors, and related teams.
Supplemental Information
How to Apply (PLEASE READ CAREFULLY): Only your State of Colorado job application will be reviewed during the initial screening; resumes and cover letters will be reviewed in later stages. Applications left blank or marked SEE RESUME will not be considered. The process includes a comparative analysis against minimum and preferred qualifications, with notifications sent via email. ADA accommodations are available; if you require a reasonable accommodation, contact the ADAAA Coordinator, Anupreet Kaur, at anupreet.kaur@state.co.us. The Department does not sponsor visas. EEO & Benefits
The State of Colorado is an equal opportunity employer and seeks to build inclusive, innovative work environments. Benefits include PERA retirement options, health/dental/vision insurance, disability coverage, FSAs, FMLA and PFML, paid holidays, leave, flexible work arrangements, and other programs. Some positions may qualify for Public Service Loan Forgiveness. Benefits details: https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs. Note
Equipment provisioning and certain onboarding tasks will occur in person on the first day of employment in the Denver office. The department supports applicants from diverse backgrounds and abilities. #J-18808-Ljbffr
JOB STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION. This announcement may be used to fill multiple openings. We are looking for a Child & Maternal Health Systems Business Analyst for the Systems Division of the Health Information Office (HIO) in the Department of Health Care Policy & Financing (HCPF). The Systems Division exists to manage and enhance computerized claims processing and information management systems for Medicaid, CHP+, and related programs, and to support audits, payments, and program management across MES and MMIS systems. This position can be fully remote from anywhere in Colorado; equipment provisioning and certain onboarding tasks will occur in person at our downtown Denver office on the first day of employment. Work location: remote within Colorado; first day onboarding in Denver Division: Systems Division, Health Information Office (HIO) Program scope: Medicaid, CHP+, and related state/federal programs
Key Responsibilities
Serve as the CMES Child and Maternal Health & Cover All Coloradans Staff Authority for the Department, overseeing system enhancement and operations related to this population. Document and enforce system policies and business rules to ensure member access to care and provider payment; ensure accurate reporting of payments. Lead interChange Payers to evaluate policies conflicting with CMS rules and ensure changes do not affect CMS certification or funding. Guide Medicaid/CHP+ program operations and finance teams to evaluate compliant options that meet program needs. Coordinate COB reporting and work with external and internal Payers to ensure accurate claims and encounters reporting. Manage CMES module integrations affecting member access, provider payments, or financial reporting; oversee enhancements impacting Health Plan Payers solutions. Provide management with decision support on system changes and policy alignment for Cover All Coloradans and Child & Maternal Health programs. Determine plan for elicitation and documentation of policies, rules, regulations, and business requirements to maintain accurate, timely, and compliant reporting of claims and COB/TPR data. Manage stakeholder and risk activities to obtain approval of business requirements from customers. Verify fiscal agent solutions meet program policies, rules, and business requirements. Communicate and determine test planning approaches for Health Plan System testing with stakeholders, vendors, and related teams.
Supplemental Information
How to Apply (PLEASE READ CAREFULLY): Only your State of Colorado job application will be reviewed during the initial screening; resumes and cover letters will be reviewed in later stages. Applications left blank or marked SEE RESUME will not be considered. The process includes a comparative analysis against minimum and preferred qualifications, with notifications sent via email. ADA accommodations are available; if you require a reasonable accommodation, contact the ADAAA Coordinator, Anupreet Kaur, at anupreet.kaur@state.co.us. The Department does not sponsor visas. EEO & Benefits
The State of Colorado is an equal opportunity employer and seeks to build inclusive, innovative work environments. Benefits include PERA retirement options, health/dental/vision insurance, disability coverage, FSAs, FMLA and PFML, paid holidays, leave, flexible work arrangements, and other programs. Some positions may qualify for Public Service Loan Forgiveness. Benefits details: https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs. Note
Equipment provisioning and certain onboarding tasks will occur in person on the first day of employment in the Denver office. The department supports applicants from diverse backgrounds and abilities. #J-18808-Ljbffr