FQHC/RHC Rates Analyst at State of Colorado, CO

About the Department

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. 

As part of the State of Colorado, HCPF offers a competitive benefits package:

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

• Medical, Dental, and Vision insurance coverage

• Automatic Short-Term and Optional Long-Term Disability Coverage

• Life and AD&D Insurance

• Flexible Spending Accounts (FSAs)

• 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

• 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 to all eligible State Employees

• Credit Union of Colorado 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. 

**Please note - equipment provisioning and certain onboarding tasks will take place in person, in our downtown Denver office, on the first day of employment.**

Position Duties

What you'll be doing:

Position calculates reimbursement rates for Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Indian Health Service (IHS); projecting budget impact of changes in rates and methodology; generating summary rate setting data; and understanding computer system changes related to FQHC and RHC reimbursement.

Furthermore, the position includes: 1) establishing rates that are set in accordance with state statute and federal laws and regulations, and that are adequate to meet quality and safety standards, 2) developing and maintaining reimbursement methodologies that ensure adequate access to needed care is maintained, 3) modifying reimbursement methodologies to ensure reimbursements to FQHCs and RHCs continue to comply with laws, regulations, industry standards, and Medicaid policy decisions.

Position will be responsible for the law, techniques and process which will allow the position to forward Department objectives. This position includes the application and knowledge of cost analysis and utilization data in order to calculate reimbursement rates for FQHC and RHC reimbursement systems. Position works under the direction of supervisor to apply the methodology for calculating reimbursement rates, including the review of calculations done by a contractor to audit FQHC and RHC cost reports and manipulate and summarize relevant cost data. Position will understand detailed rate analysis using complicated data and will forecast the fiscal impact of rates on access to care and other broad health care policy issues. Position understands the complex rate setting processes, including state and federal regulations with interpretive guidance provided by the position’s supervisor or peer leader.

Minimum Qualifications

Residency Requirement: 

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

Class Code & Classification Description: (New)

MINIMUM QUALIFICATIONS:

Six (6) years of relevant experience in data research, analytics, and data manipulation using Excel

• Master’s degree
• Research experience
• SQL or other database experience
• Experience working with large, complex data sets
• Experience interpreting State and Federal regulations
• Prior state experience related to the duties of this position
• Experience in Tableau, SAS, or other statistical and visualization packages
• Intermediate proficiency with Window-based software packages including Excel, Access, Word, and PowerPoint applications.
• Experience with generally accepted accounting principles 

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

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)

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.

Other Qualifications

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, Minnie Kaur, at [email protected].

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