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Managed Care Rate & Reconciliation Analyst

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Managed Care Rate & Reconciliation Analyst

Salary

$57,708.00 - $75,024.00 Annually

Location

Denver Metro, CO

Job Type

Full Time

Job Number

UHA04658 - 05/2025

Department

Department of Health Care Policy and Financing

Division

Finance Office

Opening Date

05/06/2025

Closing Date

5/13/2025 11:59 PM Mountain

FLSA

Determined by Position

Type of Announcement

This position is open only to Colorado state residents.

Primary Physical Work Address

303 E 17th Ave

FLSA Status

Non-Exempt; position is eligible for overtime compensation.

Department Contact Information

Kelli Dauleh, Talent Acquisition Specialist ~ [email protected]

How To Apply

Please submit an online application for this position at https://www.governmentjobs.com/careers/colorado. Reach out to the Department Contact to apply using a paper application, including any supplemental questions. Failure to submit a complete and timely application may result in the rejection of your application. Applicants are responsible for ensuring that application materials are received by the appropriate Human Resources office before the closing date and time listed.

+ Description

+ Benefits

Department Information

STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION

NOTE: This announcement may be used to fill multiple openings.

Envision yourself working at HCPF (https://www.youtube.com/watch?v=5He6If7FyDY)

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 looking for a Managed Care Rate & Reconciliation Analyst to join our Managed Care Rates BH Rates Unit !

As part of the State of Colorado, HCPF offers a competitive benefits package: (https://dhr.colorado.gov/state-employees/state-of-colorado-employee-benefits)

+ PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans

+ Medical (https://dhr.colorado.gov/state-employees/state-employee-benefits/medical-benefits) , Dental (https://dhr.colorado.gov/state-employees/state-employee-benefits/dental-insurance) , and Vision (https://dhr.colorado.gov/state-employees/state-employee-benefits/vision-insurance) insurance coverage

+ Automatic Short-Term and Optional Long-Term Disability Coverage (https://dhr.colorado.gov/state-employees/state-employee-benefits/disability-insurance)

+ Life and AD&D Insurance

+ Flexible Spending Accounts (https://dhr.colorado.gov/state-employees/state-employee-benefits/flexible-spending-accounts) (FSAs)

+ Family Medical Leave Act (FMLA) (https://dhr.colorado.gov/state-employees/time-off-leave/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 (https://dhr.colorado.gov/state-employees/time-off-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 (https://www.rtd-denver.com/fares-passes/ecopass) to all eligible State Employees

+ Credit Union of Colorado (https://www.cuofco.org/credit-union-colorado-membership-eligibility) 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 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.

Description of Job

What you'll be doing-

Position works closely with supervisors and senior analysts to:

+ Uses database software to extract, compile and interpret data.

+ Develops and completes a range of analyses and reports using statistical measures independently or under instruction from other senior analysts. Use transaction record analysis, including SQL based database extracts and statistical techniques, to produce summarized reports.

+ Collaborates with others, works on teams to accomplish work-related activities. Communicates results, problems, suggestions, or conditions with team members, internal stakeholders, and external stakeholders.

+ Performs quality reviews and provides statistical analysis support for all the programs. Researches eligibility information which forms the basis for identifying actuarially equivalent populations. Reviews financial data for correctness for the purposes of validation and reconciliation of payments.

+ Reviews State and Federal rules and regulations and evaluate the impact to managed care programs.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Residency Requirement: (New)

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

Class Code & Classification Description: (New)

H8G2XXRATE OR FINANCIAL ANALYST I (https://drive.google.com/file/d/0BwUD9Bt4G-21STRsY1BWTXVfdzA/view?usp=sharing&resourcekey=0-eTztQD0pz5qOj98bDXE7Ww)

MINIMUM QUALIFICATIONS:

Experience Only:

Five (5) years of relevant experience in Data analysis, Data manipulation using Excel

OR

Education and Experience:

+ Bachelors Degree in Economics, Mathematics, Statistics, Data Science, Finance, Public Health, or a closely related field

AND

+ 1 (one) year professional experience conducting Data analysis and Data manipulation using Excel

Preferred Qualifications & Special Qualifications:

+ Master’s degree in Economics, Mathematics, Statistics, Data Science, Finance, Public Health, or other related

+ SQL or other database experience

+ Intermediate to expert level in Excel

+ Experience in Tableau, SAS, or other statistical and visualization packages

+ Experience interpreting State and Federal regulations

+ Managed Care experience

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: (Updated)

An applicant who has been removed from an employment list or removed from consideration during the selection process may request a review by the State Personnel Director.

As an applicant directly affected by the results of the selection or comparative analysis process, you may file a written appeal with the State Personnel Director.

Review of the completed, signed and submitted appeal will be timely on the basis of written material submitted by you, using the official appeal form signed by you or your representative. This form must be completed and delivered to the State Personnel Board by email at [email protected] within ten (10) calendar days from your receipt of notice or acknowledgement of the Department’s action.

For further information on the Board Rules, you can 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/board-rules .

Supplemental Information

How to Apply (https://careers.colorado.gov/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 [email protected] .

The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.

The State of Colorado offers permanent employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for detailed information: www.colorado.gov/pacific/dhr/benefits

Please note that each agency's contact information is different; therefore, we encourage all applicants to view the full, official job announcement which includes contact information and class title. Select the job you wish to view, then click on the "Print" icon.

Employer

State of Colorado

Address

See the full announcement by clicking

the "Printer" icon located above the job title

Location varies by announcement, Colorado, --

Website

https://careers.colorado.gov/

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