Salary $52,440 - $63,396 a year job type full-time
Full job description
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 coloradansOur 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 committed to increasing the diversity of our staff and providing culturally responsive programs and servicesTherefore, we encourage responses from people of diverse backgrounds and abilities.
We are looking for a health network accountability specialist to join our health programs office (hpo) team!
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)
10 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
Discounted rtd ecopass
Reduced college tuition through csu global
Credit union of colorado membership eligibility
The ongoing covid-19 pandemic has impacted how and where we do our workDuring this pandemic, we are onboarding new employees using a hybrid approachHcpf supports flexible work arrangements and, depending on the business need and description of the position, we have options that range from fully remote, hybrid, to full-time in the officeSpecific discussions about the schedule will be discussed during the offer stage.
The accountable care collaborative (acc) delivery system division is responsible for the execution and performance of key health programs that cover and serve health first colorado membersThese programs include the acc program, the child health plan plus (chp+) program, healthy communities, and other public health programs that contribute to the achievement of the department`s mission, goals, and strategy .
The acc program management team manages the performance of the regional accountable entities (raes) of the acc and oversees the implementation of rae programs and initiatives that improve member access, reduce duplication and gaps in service and enhance quality and cost effectivenessAs a member of this team, you will be at the front line of the acc, engaging in critical and solution-oriented conversations with raes, collaborating to develop strategic innovations with other hpo and department teams, and identifying challenges and successes of the acc at the community level to potentially translate into policySuccess in this position requires a team player who takes initiative, embraces challenging problems, holds themselves accountable, seeks to continuously learn and grow, and brings a unique sense of humor and perspective to our work.
Description of job
What you`ll be doing:
Manages and drives performance in rae contract to ensure members are able to access medically necessary services and to comply with federal, state, and contract requirements related to provider network access and adequacy.
Collaborates with rae contractors to implement and manage changes and initiatives that impact provider networks.
Works with rae contractors to understand provider networks and regional relationships.
Makes program recommendations and develops solutions to address provider network adequacy challenges and innovations and to support the program management team and other staff in provider network adequacy oversight efforts.
Collaborates with qi team to seek federal approval for any required programmatic change.
Works closely with other dspi teams to ensure compliance of program.
Completes technical troubleshooting of provider network adequacy reporting.
Uses analysis provided by eqro to facilitate monitoring the adequacy of the raes provider networks and provides the program management team with information and insight.
Provides quality control oversight relative to processes around work products for network adequacy reporting.
Develops plans and processes for quarterly and annual network adequacy review.
Bridges policy and program design with operations.
Minimum qualifications, substitutions, conditions of employment & appeal rights
Bachelor`s degree from an accredited institution in a public health, public policy, social work, healthcare administration or related field and
Two years of professional experience in health policy, public administration, healthcare administration, or related field
A combination of work experience in the occupational field or specialized subject area of the work assigned to the job, which provided the same kind, amount, and level of knowledge acquired in the required education, may be substituted on a year-for-year basis for the bachelor`s degree.
A master`s or doctorate degree from an accredited college or university in a field of study related to the work assignment may be substituted for the bachelor`s degree and at the agency`s discretion, one or two years of general experience respectively.
Master`s degree in public health, public policy, social work, healthcare administration or related field
Experience in performance management and evaluation of healthcare programs and policies (i.eMedicaid systems) at the state, regional, community, or practice level
Understanding of healthcare landscape, including behavioral health at national, state, regional, and community levels
Experience with cross-functional project management including plan drafting, assessment and tracking, and stakeholder engagement
Experience communicating and collaborating with diverse audiences, including underserved populations
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.
Effective september 20, 2021, employees will be required to attest to and verify that they are fully vaccinated for covid-19, or, submit to twice-weekly serial testingUpon hire, new employees will have three (3) business days to provide attestation to their status with proof of vaccination, or begin twice-weekly serial testing for covid-19.
Testing place is to be determined and will be considered paid work time.
Note: fully vaccinated means two (2) weeks after a second dose in a two-dose series of the covid-19 vaccine, such as the pfizer or moderna vaccine, or two (2) weeks after the single-dose vaccine, such as johnson & johnson’s janssen vaccine, as defined by the state of colorado’s public health order and guidance issued by the colorado department of public health & environment.
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 representativeThis form must be delivered to the state personnel board by email (firstname.lastname@example.org), 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 to spb.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, at spb.colorado.gov under rules.
Apply Now (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 processTherefore, it is paramount that you clearly describe all your relevant experience on the application itselfApplications left blank or marked `see resume` will not be consideredYour application will be reviewed against the minimum qualifications for the positionIf 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 positionApplications 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 interviewDepending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidatesApplicants 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 applyThe state of colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve themTherefore, 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 individualsAs 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 hardshipIf 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, debra becerra, at email@example.com or call 303-866-4438.
The department of health care policy & financing does not offer sponsored visas for employment purposes.