OCL Projects, PCSP Waiver Logic and Enrollment Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5041514) Apply  OCL Projects, PCSP Waiver Logic and Enrollment Analyst Salary $71,544.00 - $94,872.00 Annually Location Denver Metro, CO Job Type Full Time Job Number UHA04591 08/12/2025 Department Department of Health Care Policy and Financing Division Community Living Office Opening Date 08/13/2025 Closing Date 8/24/2025 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 ~ jessica.bosick@state.co.us 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 AT TIME OF APPLICATION NOTE: This announcement may be used to fill multiple openings.   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. 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 Office of Community Living: The Office of Community Living (OCL or Office) exists as part of the Department of Health Care Policy and Financing (the Department), which is the federally recognized single state agency to administer the Colorado Medicaid program. The Office administers the state’s Long-Term Care (LTC) Services and Supports (LTSS) programs. The Office provides oversight and monitoring for the state’s system for access to LTSS programs. Staff within the Office are responsible for stakeholder relations, policy development and implementation, contract management and performance, program administration, operational support of case managers and direct services providers, and overall LTC Medicaid program performance. The Operations and Administration Division: The Operations and Administration Division (Division) within the Office of Community Living (Office) acts as the service and support entity of the Office. The Division includes financial oversight, contract management, administrative support, and systems support for the day-to-day activities of the Office. The HCBS IT Operations, Provider Payment, and Credentialing Section within the Division: + Leads and coordinates the Office’s HCBS IT implementation strategy across the Department’s vendor operated Commercial Off the Shelf (COTS) and state-operated IT applications. + Creates and maintains product roadmaps, long-range strategic plans, and coordination on implementation across the Health Information Office, Behavioral Health Administration, and the Office of eHealth Innovation, in supporting the charting the Office’s strategic vision. + Steers, articulates, and prioritizes the policy goals for the Care and Case Management System, , and the Colorado LTSS IT ecosystem, including the Bridge, as articulated by the policy leads across the Office. + Ensures the Office meets state and federal requirements regarding data sharing and interoperability. This includes steering the overall provider enrollment/credentialing strategy, timely support of escalated provider payment and prior authorization issues, ensuring identified problems find resolution through automation, increased data sharing, and strategic upgrades to the existing IT ecosystem. + Serves as the principal liaisons with other Offices and the Governor’s Offices of eHealth Innovation and Information Technology. + Provides strategic and operational oversight of the Care and Case Management Operations Unit, and manages term-limited funding as that funding pertains to IT projects. The Care and Case Management External Operations Unit within the HCBS IT Operations, Provider Payment, and Credentialing Section: + Provides Business Analysis and Application oversight for the Department’s electronic case management tool, currently the Care and Case Management System (CCM), which is an online database for Case Management Agencies (CMAs) and contractors to perform reporting and document client assessments, service plans, log notes, critical health incidents, and other information crucial to monitoring and compliance + Communicates with the CMA staff, provisioning of user logins for the system, troubleshooting defects, and writing and approving test plans. + Provides operational support for provider enrollment activities, as well as technical acumen of the waiver logic for the Person-Centered Support Plan. Description of Job The Care and Case Management External Operations Unit welcomes your application for the OCL Projects, PCSP Waiver Logic, and Enrollment Analyst position. Responsibilities in this position include: + Planning, project oversight, vendor management, and implementation work related projects for the Care and Case Management (CCM) Tool. + Project prioritization, defining and directing the business requirements gathering process, managing timelines, any changes in policies, and providing sign off for all the system requirements. + HCBS waiver logic embedded in the Person-Centered Support plan in the Care and Case Management System, which is a programmed set of rules and criteria that assigns benefits based on member eligibility details. + Translate PCSP waiver logic policy into actionable, clear IT requirements for implementation into the Care and Case Management System. + Logic underpinning the Items to be Addressed in the Support Plan (IASP). + Validate LOC/PCSP logic functionality; directing staff in conducting unit and functional testing of the LOC and PCSP as required by CCM Projects. + HCBS and Case Management agency provider data staff authority; management relies on the role’s understanding of the provider enrollment datasets in determining staffing patterns for enrollment, PHE unwind support, revalidation, end user training, and short- term projects requiring additional, temporary staffing oversight. + HCBS provider application; management relies on the role’s understanding of how the electronic application functions to conceptualize, develop, and implement system, training, and process improvements to the provider module of the Medicaid Management Information System (MMIS + Approve escalated Home and Community Based Services (HCBS) providers and case management agencies’ applications, ensuring compliance with Medicaid provider enrollment regulations. + Content and utility of end user reports for the Person-Centered Support plan, eLTSS standards, the Admission, Discharge, and Transfer data feeds relative to HCBS members, Functional Assessment Standardized Items (FASI) and other interoperability initiatives in the CCM. + Develop strategy relative to Personal Health Records (PHRs), data-based strategies for hospital discharge planning, critical incident tracking, and care coordination. + Lead and coordinate eLTSS projects’ scope where necessary, with the Health Information Office and the Governor’s Office of eHealth Innovation to align with the Governor’s eHealth strategy and long-term goals. Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights MINIMUM QUALIFICATIONS: Experience Only: Seven (7) years of relevant experience in creating project plans, creating tracking templates, facilitating meetings, and tracking projects through to completion, documenting processes, creating workflows, or training/assisting users and/or testers on large computer systems, preferably Health IT systems like claims processing engines or care/case management platforms. OR Education and Experience: Graduation from an accredited college or university with a Bachelor’s degree in Business or Health Care Administration, Information Systems, Applied Technology, Human Services or Social Services or a field of study related to the work assignment AND Three (3) years of: Professional experience in creating project plans, creating tracking templates, facilitating meetings, and tracking projects through to completion. Professional experience documenting processes, creating workflows, or training/assisting users and/or testers on large computer systems, preferably Health IT systems like claims processing engines or care/case management platforms. PREFERRED QUALIFICATIONS + Prior state experience related to the duties of this position + Provider Enrollment or credentialing experience in a health care context. + Electronic Health Record (EHR) or other healthcare interoperability experience. + Experience project management support to term-limited or ongoing projects + Experience leading projects, workgroups and stakeholder engagement efforts. + Three or more years of professional experience in care coordination and/or long-term services and supports (LTSS) case management or administration, regulation and compliance, policy development, program management or an occupational field closely related to the work assigned to the position. 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 (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 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, anupreet.kaur @state.co.us (anupreet.kaur@state.co.us) . 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 & Financing? If so, please list their names here. Otherwise, please list N/A. 03 Are you willing to accept an offer within the posted salary range? + Yes + No 04 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. 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 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