"Alerted.org

Enterprise Solutions Integration (ESI) Manager

Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4960379)

Apply



Enterprise Solutions Integration (ESI) Manager

Salary

$89,520.00 - $116,400.00 Annually

Location

Denver Metro, CO

Job Type

Full Time

Job Number

UHA04624 06/02/2025

Department

Department of Health Care Policy and Financing

Division

Health Information Office

Opening Date

06/11/2025

Closing Date

6/24/2025 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 Denver, CO 80203

FLSA Status

Exempt; position is not eligible for overtime compensation.

Department Contact Information

Jessica Bosick, 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

+ Questions

Department Information

STATE OF COLORADO RESIDENCY REQUIRED

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.

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.

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

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.

The work unit exists to manage and enhance computerized claims processing and information management systems in order to assure timely and accurate Medicaid and Child Health Plan Plus (CHP+) claims processing and payments in an environment of rapid policy change. It also exists to improve the management of the Medicaid programs data integration files transmission across the Colorado Medicaid Enterprise ecosystem. The work section is responsible for researching, verifying and validating the transmission of data and integration functions and processes through the Enterprise Solutions Integration Platform and across the Colorado Medicaid Enterprise ecosystem which includes 16 medicaid modules, processing medical claims and encounters, member eligibility, medical and pharmacy prior authorizations, pharmacy claims, third party liability data and a host of other benefits and services for Colorado Medicaid. This unit enforces data and integration governance through the Software Development Life Cycle (SDLC) phases and integration industry best practices to ensure consistency with all Module Vendors across the CMES ecosystem. This includes working with Module Contract Vendors, all Department Staff including the Enterprise Testing Vendor to elicit, review and approve requirements, review and approve Module Vendor design and development documentation, review and approve user acceptance testing activities such as test execution, test scenarios, or testing system processes such as End to End integration testing in the test environment to determine the accuracy of the system functionality. Additionally, the work unit supports the various State and Federal regulatory policy and audits of the systems, and Medicaid claims reimbursement, provider enrollment and medical benefit coverage, by providing research and validation of the data mapping and transmissions of the interface files and APIs to ensure Medicaid data is mapped according to the State and Federal regulatory policies and rules.

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

This position is the Program Manager for the Enterprise Solutions Integration Unit, formally known as MIDA under the ESI Division. This position manages the ESI work section business processes with the Module Contract Vendor, Department Staff and Stakeholders and reports successes and issues to the ESI Division Director. This position analyzes and communicates complex State and Federal regulations statutes to successfully implement systems requirements and policy initiatives for the Colorado Medicaid Enterprise Solutions (CMES) and recommends alternative solutions to the ESI Division Director.

Responsibilities in this position include:

+ Provide the Enterprise Solutions Integration Unit, CMES Module Vendors and the Department Staff with system and integration expertise in developing appropriate business solutions for implementing system changes to the CMES Platform and implementing State and Federal regulatory mandates.

+ Enforce the Medicaid Information Technology Architecture (MITA) compliance, and other regulatory and/or strategic initiatives related to Medicaid Health IT/Health IE (Information Exchange).

+ Manage data integration business process changes, Medicaid data modeling changes, recommending changes to Software Development Life Cycle documents including data conversion plans and strategy documents, reviewing and implementing policy changes and performing other duties as assigned, to ensure that the Division meets its obligations and goals.

+ Focus on change management efforts for all integration projects, including changes to data and integration business processes, systems and technology, job roles and organization structures.

+ Align with the EPMO Office, the MMIS Manager, the EDW Manager, the PBMS Manager and other HIO Directors in developing the Department’s IT strategies for the CMES Platform, including assisting in the coordination for implementing all new and existing modules.

+ Research and propose in and out of the box solutions and strategies for module enhancements.

+ Supervise a unit of individuals responsible for coordinating and enforcing the SDLC processes throughout the ESI Integration Platform and CMES Module Ecosystem, for all associated projects outlined by the EPMO Office, State’s budget requests and the Federal Advanced Planning and Operations documents.

+ Develop onboarding documents, performance plans, goals and performance objectives for the unit staff to successfully meet the objectives and goals for the ESI Division.

+ Collaborate with the EPMO Office, Program & Policy offices, and Contract Vendors to identify costs, schedule, and resources for project initiatives.

+ Clarify information and decisions from all stakeholders in the preparation of both temporary and permanent solutions to meet the business needs.

+ Assist the Department with activities required by Federal oversight agencies regarding Federal funding, compliance regulations, and strategic plans.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

MINIMUM QUALIFICATIONS:

There are two ways to qualify for this position:

Option 1:

Experience Only:

8 years of experience in managing business processes and supervision of staff for large, complex systems, managing teams and vendors while guiding the Software Development Life Cycle to ensure successful project delivery.

Option 2:

Education and Experience:

Bachelors Degree in Health Care Administration, Business Administration or a related field

AND

Four (4) years of experience in managing business processes and supervision of staff for large, complex systems, managing teams and vendors while guiding the Software Development Life Cycle to ensure successful project delivery.

Appropriate education will substitute for the required experience on a year-for-year basis. Relevant education will be calculated as the following:

+ An associate will count as two years of experience

+ A bachelors will count as four years of experience

+ A masters degree will count for six years of experience

+ A doctorate or juris doctorate degree will count for seven years of experience

Preferred Qualifications:

+ Prior state experience related to the duties of this position.

+ Experience working in a large claims processing system and/or knowledge of Medicaid and Pharmacy benefits and services.

+ A proven track record in program management assisting in the development of programs to support an organization’s strategic direction, creating and managing long term goals, complex problem solving, understanding and managing data interface files, vendor management, writing program funding proposals.

+ Professional experience working as a Systems Business Analyst.

+ Professional experience documenting business requirements and reviewing and approving design and development documents for large scale medical claims processing system or medical information system.

+ Professional experience working for or in partnership with a State Medicaid Agency.

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:

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 ([email protected]), 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 tospb.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, atspb.colorado.govunder 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.

01

All HCPF positions are security sensitive positions and require potential employees to undergo a criminal record background check. As a condition of employment, you will be required to submit to pre-employment screening if offered the position. Are you willing to meet this requirement?

+ Yes

+ No

02

Do you have any relatives or significant others working at the Department of Health Care Policy and Financing? If so, please list their names here. Otherwise, please list N/A

03

Per the requirements of the Step Pay Program implemented on July 1, 2024, any State employee must be paid a rate that is equal to or greater than the appropriate step pay rate within their classification’s pay range based on completed years in their current class series as of June 30. All current and former State employees must ensure that your entire work history within the State Classified System, including at Institutions of Higher Education, is indicated in your application so that your time-in-series can be calculated accurately. Please verify that this information is included in your application in the supplemental questions.

04

Are you willing to accept an offer within the posted salary range?

+ Yes

+ No

05

Former state employees who were disciplinarily terminated or resigned in lieu of termination must disclose the information on the application. In the space below, please provide an explanation as to why the prior termination or resignation should NOT disqualify your application from the current position. Otherwise, please list N/A.

06

Describe a recent example where you managed a complex, cross functional technology project, including your approach to risk and stakeholder management.

07

Describe your approach to Customer Service as it relates to managing a large system implementation.

08

Provide a recent example where you were directly responsible for managing business process improvement in a professional setting for a large claims system.

09

List any additional relevant experience you would like us to consider in determining if you meet the qualifications of this position. Please, include the months and years relevant to the experience you describe.

Required Question

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/

Apply

Please verify your email addressVerify Email