Health Care Policy And Financing
Managed Care Technology Administrator
Health Care Policy And Financing, Denver, Colorado, United States, 80285
Colorado Department of Health Care Policy & Financ
STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION
NOTE: This announcement may be used to fill multiple openings.
Envision yourself working at HCPF
OPTION FOR REMOTE WORK IN STATE
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 committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of diverse backgrounds and abilities.
Competitive benefits
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 moreinformation, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs. https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs.
Description of Job
The ACC/Delivery Systems Division within the Cost Control and Quality Improvement Office is responsible for the design, administration and oversight of the Accountable Care Collaborative (ACC) program, Enrollment Broker services, and other population health and administrative programs.
Within the Delivery Systems Division, the Program Operations Section (POS) efficiently manages the Regional Accountable Entities (RAE) and the Enrollment Broker (EB) as a part of ACC Phase II. The POS contributes to the Division goals through administration of the RAE and Managed Care Organization (MCO) contracts, the Enrollment Broker (EB) contract, eConsult contract, and programmatic system performance.
The Cost Control and Quality Improvement Office welcomes your interest in the Managed Care Technology Administrator position. This position is the staff authority in determining enrollment and attribution policy, and health plan network management.
Responsibilities in this position include: Support Program Operations Unit and other staff within the Section as needed on all contract related issues related to managed care eligibility, enrollment, UAT testing, and RAE provider network management. Oversee the development of standardized deliverable templates for managed care contracts to allow for streamlined reporting of contract required data and input into data warehouse. Oversee key enrollment operations processes and provide support to leadership and staff for various managed care enrollment/eligibility activities. Oversee RAE provider contracting operations and provide support to RAEs as well as internal stakeholders for processes related to RAE provider network management. Act as technical resource related to enrollment, eligibility, PCMP provider network management, UAT testing, encounter SLA performance, and performance metrics.
STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION
NOTE: This announcement may be used to fill multiple openings.
Envision yourself working at HCPF
OPTION FOR REMOTE WORK IN STATE
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 committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of diverse backgrounds and abilities.
Competitive benefits
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 moreinformation, go to https://www.colorado.gov/pacific/dhr/student-loan-forgiveness-programs. https://dhr.colorado.gov/dhr-resources/student-loan-forgiveness-programs.
Description of Job
The ACC/Delivery Systems Division within the Cost Control and Quality Improvement Office is responsible for the design, administration and oversight of the Accountable Care Collaborative (ACC) program, Enrollment Broker services, and other population health and administrative programs.
Within the Delivery Systems Division, the Program Operations Section (POS) efficiently manages the Regional Accountable Entities (RAE) and the Enrollment Broker (EB) as a part of ACC Phase II. The POS contributes to the Division goals through administration of the RAE and Managed Care Organization (MCO) contracts, the Enrollment Broker (EB) contract, eConsult contract, and programmatic system performance.
The Cost Control and Quality Improvement Office welcomes your interest in the Managed Care Technology Administrator position. This position is the staff authority in determining enrollment and attribution policy, and health plan network management.
Responsibilities in this position include: Support Program Operations Unit and other staff within the Section as needed on all contract related issues related to managed care eligibility, enrollment, UAT testing, and RAE provider network management. Oversee the development of standardized deliverable templates for managed care contracts to allow for streamlined reporting of contract required data and input into data warehouse. Oversee key enrollment operations processes and provide support to leadership and staff for various managed care enrollment/eligibility activities. Oversee RAE provider contracting operations and provide support to RAEs as well as internal stakeholders for processes related to RAE provider network management. Act as technical resource related to enrollment, eligibility, PCMP provider network management, UAT testing, encounter SLA performance, and performance metrics.