<p>STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION</p> <p>NOTE: This announcement may be used to fill multiple openings.</p> <p>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.</p> <p>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. </p> <p>We are looking for a Third Party Liability & Cost Avoidance Section Manager to join our Fraud, Waste & Abuse Division!</p> <p>As part of the State of Colorado, HCPF offers a competitive benefits package:</p> <ul> <li> <p>PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans</p> </li><li> <p>Medical, Dental, and Vision insurance coverage</p> </li><li> <p>Automatic Short-Term and Optional Long-Term Disability Coverage</p> </li><li> <p>Life and AD&D Insurance</p> </li><li> <p>Flexible Spending Accounts (FSAs)</p> </li><li> <p>Family Medical Leave Act (FMLA) job protection and State of Colorado Paid Family Medical Leave (PFML)</p> </li><li> <p>11 Paid Holidays Annually and Accrued Annual and Sick Leave</p> </li><li> <p>Accrued Sick Leave for State of Colorado Temporary Employees</p> </li><li> <p>Flexplace and Flextime work arrangements</p> </li><li> <p>Variety of discounts on services and products available through the State of Colorado's Work-Life Employment Discount Program</p> </li><li> <p>Free RTD EcoPass to all eligible State Employees</p> </li><li> <p>Credit Union of Colorado Membership Eligibility</p> </li><li> <p>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</p> </li></ul> <p>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. </p> <p>Please note - equipment provisioning and certain onboarding tasks will take place in person, in our downtown Denver office, on the first day of employment.</p> <p>This position oversees the daily operations of the section, which includes managing several individuals with staff authority, various programs required under state and federal law, and multiple contracts. </p> <p>Typical duties include, but are not limited to:</p> <ul> <li>Leading the procurement processes and contract negotiations of the recovery and cost avoidance contracts, including the drafting of RFPs for solicitation, drafting of the statement of work, and drafting, negotiation, and execution of the final contract language </li><li>Implementing negotiated contracts, including oversight of internal system implementations, as well as external implementation of vendor functionality </li><li>Managing, directing and advising vendor performance and delivery of services, including oversight of vendor accountability and ongoing enhancements to the services  </li><li>Planning, prioritizing, assigning, analyzing and monitoring workflow, and maintaining appropriate staffing levels </li><li>Reviewing the quality and quantity of work standards and deadlines for deliverables to meet section and program goals and objectives </li><li>Establishing work schedules, reviewing and approving worktime and absences </li><li>Initiating the hiring process, providing subject matter expertise to HR during the comparative analysis process, interviewing candidates </li><li>Staff authority over all cost avoidance and recovery system implementations and functionality </li><li>Identifying and pursuing all recovery opportunities, whether previously established or as new opportunities, to ensure Medicaid is the payor of last resort </li><li>Designing systems, guidelines, processes, and standards for all recovery efforts </li><li>Advising Department leadership on state and federal legal authority on third party liability and recoveries </li><li>Developing and evaluating proposed rules and legislation for Department leadership decision-making, including providing feedback and responses on budget initiatives and fiscal notes </li><li>Developing the annual section budget for new procurements, conference attendance, and other operating needs </li><li>Other duties as assigned </li></ul> <p>Residency Requirement:</p> <p>This posting is only open to residents of the State of Colorado at the time of submitting your application. </p> <p>Class Code & Classification Description:</p> <p>H1A2XXPROGRAM MANAGEMENT I</p> <p>MINIMUM QUALIFICATIONS:</p> <p>Experience Only:</p> <p>Eight (8) years of professional experience in healthcare and/or government work related to the work assigned to the position.</p> <p>OR</p> <p>Education and Experience:</p> <p>A bachelor's degree from an accredited institution in Healthcare, Public Policy, Business or another related field of study to the work; AND four (4) years healthcare and/or government work related to the work assigned to the position.</p> <p>Appropriate education will substitute for the required experience on a year-for-year basis. Relevant education will be calculated as the following:</p> <ul> <li> <p>An associate will count as two years of experience</p> </li><li> <p>A bachelors will count as four years of experience</p> </li><li> <p>A masters degree will count for six years of experience</p> </li><li> <p>A doctorate or juris doctorate degree will count for seven years of experience</p> </li></ul> <p>PREFERRED QUALIFICATIONS</p> <ul> <li> <p>Prior state experience related to the duties of this position </p> </li><li> <p>At least three years of prior or current state experience specifically related to Medicaid.</p> </li><li> <p>At least three years of prior or current professional experience working for or with commercial insurance companies and the coordination of payors  </p> </li><li> <p>At least three years of prior or current professional experience managing and collecting recoveries from third parties like Medicare, commercial insurance companies, healthcare providers, other insurance carriers, etc</p> </li><li> <p>Prior professional experience in contract management and vendor oversight</p> </li><li> <p>Prior professional experience overseeing complex financial reporting and data analytics</p> </li></ul> <p>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. </p> <p>CONDITIONS OF EMPLOYMENT:</p> <ul> <li> <p>All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.</p> </li><li> <p>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.</p> </li></ul> <p>Appeal Rights:</p> <p>An applicant who has been removed from an employment list or removed from consideration during the selection process may request a review by the State Personnel Director.</p> <p>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.</p> <p>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 dpa_state.personnelboard@state.co.us within ten (10) calendar days from your receipt of notice or acknowledgement of the Department's action.</p> <p>For further information on the Board Rules, you can 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/board-rules.</p> <p>How to Apply (PLEASE READ CAREFULLY)</p> <p>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.</p> <p>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.</p> <p>Comparative Analysis Process</p> <p>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.</p> <p>Failure to submit properly completed documents by the closing date will result in your application being rejected.</p> <p>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.</p> <p>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 anupreet.kaur@state.co.us.</p> <p>The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.</p>