What are the responsibilities and job description for the Child and Youth Medicaid System Analyst IV - Hybrid position at State of Colorado Job Opportunities?
Department Information
Most State of Colorado employees are eligible for a great benefit package! Please see the Supplemental Information section below for details!
This position is open only to Colorado state residents.
Please note: This recruitment may be used to fill multiple vacancies.
About the Unit:
The Office of Children, Youth and Families (OCYF) exists to manage internal programs and divisions as well as all external activities, including the supervision of 64 counties’ social/human services for compliance with Federal and State statutes and regulations.
The OCYF Medical Team consists of the Child Welfare Medicaid Team and the Clinical Review Team. Both teams ensure that children and youth in the child welfare and youth services systems have a more seamless connection to physical and behavioral healthcare services, which improves health outcomes, minimizes harm to children and youth, and ensures timely permanency planning. The Medicaid Team focuses on identifying and providing solutions to technical gaps in the Medicaid system and proposing strategic changes to minimize barriers in accessing services or payment. The Clinical Review Team focuses on in depth review of clinical assessments, diagnoses, treatment history, responses to therapeutic modalities, and identification of appropriate ongoing treatment needs and supports for children and youth with high acuity needs.
Child Welfare Medicaid programs are managed by OCYF within CDHS but rely on cross-agency collaboration for successful implementation. OCYF is responsible for the specialized population, while HCPF is responsible for providing the benefits and services. HCPF is responsible for overseeing Medicaid enrollment, eligibility, and termination for all who receive Medicaid and are the experts in eligibility and benefits policy. CDHS is responsible for the child welfare-involved population and all the services they need. Child Welfare Medicaid requires subject matter expertise in child welfare policy, rules, and statutes at a level that cannot be easily achieved at HCPF alone. Conversely, Child Welfare Medicaid requires subject expertise in Medicaid policy, rules, and statute at a level that cannot be easily achieved at CDHS alone. Beyond Medicaid enrollment, one of the most significant barriers to accessing treatment beds is state processes for efficiently maximizing Medicaid funding to support that treatment. OCYF has increasingly encountered incidents in which children and youth in need of residential treatment are unable to access that treatment because it is either outside of their Regional Accountable Entity (RAE), the child is not enrolled in Medicaid or is enrolled incorrectly, or the facility is unsure how to bill Medicaid for treatment appropriately.
The Child Welfare Medicaid Team functions as 1) navigators for child welfare-involved families, county departments of human/social services, as well as for 24/7 providers serving these children and youth, 2) strategic partners in ensuring recurring barriers to Medicaid access are identified, and 3) SMEs who are continually interpreting and translating these identified barriers into proposed technical and system level solutions. The team ensures successful eligibility enrollment, facilitates access to care and appropriate billing, addresses systematic barriers across systems, and provides recommendations on how to simplify and gain efficiencies in Child Welfare Medicaid. These staff also work with counties, Regional Accountability Entities (RAEs), and providers to troubleshoot Medicaid-related treatment issues, a key barrier towards accessing specialized residential care, psychiatric evaluations, and other services for youth with high acuity needs. This role of Child and Youth System Analyst serves as the staff data system authority spanning CDHS, HCPF and OIT to analyze and design systems, processes and technical work solutions that directly impact all agencies’ ongoing operational decisions on how to troubleshoot and prevent Medicaid-related service interruptions from the lens of feasible technical fixes to multiple interfacing systems. Through child welfare Medicaid understanding and technical expertise, this SME is the primary data system interface with the Trails, CBMS and interChange technical teams.
Children and youth in child welfare who are eligible for Medicaid encounter additional barriers to accessing needed physical and behavioral health care due to the various funding streams, complex custody, and regulations specific to the child welfare population. CDHS, Health Care Policy and Financing (HCPF), and the Office of Information Technology (OIT) completed a root cause analysis in 2021 finding approximately 1,000 children and youth who experienced eligibility disruptions. These eligibility disruptions represent instances where children and youth attempted to access critical physical or behavioral health care services, including medications, and their access was at best delayed or at worst denied.
The OCYF Medical Team consists of the Child Welfare Medicaid Team and the Clinical Review Team. Both teams ensure that children and youth in the child welfare and youth services systems have a more seamless connection to physical and behavioral healthcare services, which improves health outcomes, minimizes harm to children and youth, and ensures timely permanency planning. The Medicaid Team focuses on identifying and providing solutions to technical gaps in the Medicaid system and proposing strategic changes to minimize barriers in accessing services or payment. The Clinical Review Team focuses on in depth review of clinical assessments, diagnoses, treatment history, responses to therapeutic modalities, and identification of appropriate ongoing treatment needs and supports for children and youth with high acuity needs.
Child Welfare Medicaid programs are managed by OCYF within CDHS but rely on cross-agency collaboration for successful implementation. OCYF is responsible for the specialized population, while HCPF is responsible for providing the benefits and services. HCPF is responsible for overseeing Medicaid enrollment, eligibility, and termination for all who receive Medicaid and are the experts in eligibility and benefits policy. CDHS is responsible for the child welfare-involved population and all the services they need. Child Welfare Medicaid requires subject matter expertise in child welfare policy, rules, and statutes at a level that cannot be easily achieved at HCPF alone. Conversely, Child Welfare Medicaid requires subject expertise in Medicaid policy, rules, and statute at a level that cannot be easily achieved at CDHS alone. Beyond Medicaid enrollment, one of the most significant barriers to accessing treatment beds is state processes for efficiently maximizing Medicaid funding to support that treatment. OCYF has increasingly encountered incidents in which children and youth in need of residential treatment are unable to access that treatment because it is either outside of their Regional Accountable Entity (RAE), the child is not enrolled in Medicaid or is enrolled incorrectly, or the facility is unsure how to bill Medicaid for treatment appropriately.
The Child Welfare Medicaid Team functions as 1) navigators for child welfare-involved families, county departments of human/social services, as well as for 24/7 providers serving these children and youth, 2) strategic partners in ensuring recurring barriers to Medicaid access are identified, and 3) SMEs who are continually interpreting and translating these identified barriers into proposed technical and system level solutions. The team ensures successful eligibility enrollment, facilitates access to care and appropriate billing, addresses systematic barriers across systems, and provides recommendations on how to simplify and gain efficiencies in Child Welfare Medicaid. These staff also work with counties, Regional Accountability Entities (RAEs), and providers to troubleshoot Medicaid-related treatment issues, a key barrier towards accessing specialized residential care, psychiatric evaluations, and other services for youth with high acuity needs. This role of Child and Youth System Analyst serves as the staff data system authority spanning CDHS, HCPF and OIT to analyze and design systems, processes and technical work solutions that directly impact all agencies’ ongoing operational decisions on how to troubleshoot and prevent Medicaid-related service interruptions from the lens of feasible technical fixes to multiple interfacing systems. Through child welfare Medicaid understanding and technical expertise, this SME is the primary data system interface with the Trails, CBMS and interChange technical teams.
Children and youth in child welfare who are eligible for Medicaid encounter additional barriers to accessing needed physical and behavioral health care due to the various funding streams, complex custody, and regulations specific to the child welfare population. CDHS, Health Care Policy and Financing (HCPF), and the Office of Information Technology (OIT) completed a root cause analysis in 2021 finding approximately 1,000 children and youth who experienced eligibility disruptions. These eligibility disruptions represent instances where children and youth attempted to access critical physical or behavioral health care services, including medications, and their access was at best delayed or at worst denied.
Description of Job
Hybrid Expectations: 2 days/week in office at 1575 Sherman St or at another location if applicable (such as on site with a county DHS, at a residential center, etc)
About the Position:
This role is ideal for a self-starter who wants to join a motivated team to make an impact! The small group you’ll be joining is hardworking, fun and dedicated to the CDHS mission of people who help people! A mighty team of two (at the moment), we hope to expand our Medicaid collective to include a team member who brings a balance of analytical thinking and strategic foresight. Our day to day is never the same, whether we are assisting members with Medicaid access, creating new job aids, meeting with county partners, or brainstorming process improvement, we can promise you will end each day feeling challenged and rewarded by the work you are doing. The team you’ll be joining mirrors many of CDHS’s values and leans in to being relational, balanced, accountable, strengths-based and transparent. Our north star always comes back to the people of Colorado that we serve.
This role provides subject matter expertise and is respected as the primary data system authority on the complex intersection of child welfare and Medicaid access by multiple entities and teams including but not limited to: Colorado Department of Human Services (CDHS) Division of Child Welfare, Colorado Department of Health Care and Policy Financing (HCPF) Colorado Medicaid services, the Governor’s Office of Information Technology (OIT), Colorado Benefit Management System (CBMS), Child Welfare Trails database, Colorado interChange’s provider-facing systems. This role has unique expertise in understanding the technical data systems above from three different state agencies (CDHS, HCPF and OIT). Several agency staff understand one agency’s systems or another’s, but this role is uniquely tasked with analyzing all agencies’ data systems and functioning as the technical SME bridge between the three, and designing system improvements. This position possesses specialized and unique expertise in understanding how to analyze and design data systems, processes and technical work solutions that directly impact all agencies’ ongoing operational decisions on how to troubleshoot and prevent Medicaid-related service interruptions from the lens of feasible technical fixes to multiple interfacing systems. Through child welfare Medicaid understanding and technical expertise of the relevant data systems, this SME is the primary technical interface with the Trails, CBMS and interChange technical teams. This role provides essential and unique counsel to multi-agency leadership who rely on this for critical decision-making in systemic technical barrier mitigation and system improvement. This bridging expertise directly informs OCYF and CDHS leadership in critical decision-making on the process- and technical-level barrier removal to Medicaid access for children and youth in Colorado.
This position works closely with the OCYF Medical Director, and is part of a Child Welfare Medicaid Team working as an expert resource to help families, counties, and providers in navigating Medicaid enrollment, ensuring consistent access to care, and removing barriers to Medicaid access for the child welfare population and the Division of Youth Services (DYS) community-placed youth.
Job Duties:
- Provides data system subject matter expertise and collaboration in several areas, including but not limited to: Colorado Department of Human Services (CDHS) Division of Child Welfare, Colorado Department of Health Care and Policy Financing (HCPF) Colorado Medicaid services, Colorado Benefit Management System (CBMS), Child Welfare Trails database, Colorado interChange’s provider-facing systems.
- Serves as backup to the Strategy Lead to facilitate regularly scheduled CDHS Medicaid working sessions, utilizing a team of problem solvers in assessing existing processes for accessing Medicaid and determining how to individualize that process to meet specific children and youth barriers to access.
- Translates proposed programmatic solutions into operationalizable data system improvements and technical fixes and works as the primary liaison to the Trails, CBMS and interChange technical teams.
- Provides analysis and consultation on how to individualize existing guidelines to meet specific and unique member needs enabling each child and youth in the child welfare system to have a more seamless connection to physical and behavioral healthcare services.
- Serves as a navigator for youth, child welfare-involved families and county departments of human/social services to ensure successful eligibility enrollment and continuous access to care, especially in situations where geographic location and service providers may shift throughout the youth’s treatment and placement life cycle.
- Provides individual case review for 24/7 community providers serving these children and youth to determine accurate and appropriate billing options based on existing policy and guidelines to maximize Medicaid funding to support the availability of needed treatment.
- Increases the number of training resources and learning opportunities related to Child Welfare Medicaid and reduces the response time for Trails Child Welfare Medicaid Help Desk Tickets.
- Collaborates with data system partners in setting policy and monitoring related to accessing Medicaid services for children and youth in the child welfare and DYS systems.
- Establishes continuous quality improvement systems for accessing Medicaid services and provides the primary linkages between state agencies (CDHS and HCPF) and their multiple database systems including Trails, Colorado Benefits Management System (CBMS), Colorado interChange’s provider-facing systems, Continuous Eligibility and Former Foster Care, etc.
- Reduces the number of errors and exceptions for Child Welfare Medicaid programs through the development and implementation of continuous quality improvement processes.
- Analyzes the current data system infrastructure for accessing Medicaid for specialized populations in the child welfare system including foster care, adoption, emancipation, and Division of Youth Services (DYS) community-placed youth.
- Determines what processes are needed to operationalize a Child Welfare Medicaid system that is largely devoid of technical barriers to accessing health care services.
- Critically evaluates these processes and provides data system improvement recommendations to both CDHS and HCPF to ensure technical processes support that children and youth are enrolled in Medicaid appropriately, transferred between Regional Accountability Entities (RAEs) efficiently as residential locations change, and maintain continuous access to health care services.
- Provides system level data improvement recommendations to both CDHS and HCPF to increase efficiency and decrease operational barriers to Medicaid access.
- Other Duties as assigned.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
Important Note: Please review your application to ensure completion. For the most equitable applicant experience, CDHS' hiring teams consider only the contents of your application to determine meeting minimum qualifications and for the comparative analysis process. Experience is calculated on a full-time equivalency basis, therefore, it is important to accurately notate the hours you averaged per experience section entry. Volunteer work or related type of experience may be used to meet the qualifications, but must be clearly documented. It is paramount that in the experience portion of the application, the applicant describes the extent to which they possess the education, experience, competencies and background as they relate to the duties outlined in the job announcement.
Minimum Qualifications:
- Seven (7) years of experience in an occupational field related to the work assigned to the position.
Education and Experience:
- A combination of related education and/or relevant experience in an occupation related to the work assigned equal to seven (7) years.
Preferred Qualifications:
The preferred experience, competencies and abilities are highly desirable for this position and will be considered in selecting the successful candidate:
The preferred experience, competencies and abilities are highly desirable for this position and will be considered in selecting the successful candidate:
- Relevant State of Colorado experience
- Exceptional leadership and communication skills to foster collaboration and engagement
- Ability to facilitate problem-solving projects and teams
- Must be able to work independently as well as with a team
- Experience with child welfare policy, rules and statutes
- Experience with Medicaid policy, rules and statutes
- Experience with Medicaid systems - TRAILS, CBMS, interChange
- Experience with ticketing systems - ie. Service Hub, Salesforce
- Excellent decision-making skills
- Ability to build and maintain effective relationships with internal and external stakeholders
- Ability to manage and prioritize multiple project tasks to meet deadlines
- Ability to work in an unstructured environment, effectively managing time, logical problem-solving and analytical skills with demonstrated attention to detail and follow through
- Strong interpersonal skills with the ability to effectively engage and communicate with diverse audiences, various levels of the organization, and individuals with different knowledge levels
Conditions of Employment:
- A pre-employment criminal background check will be conducted as part of the selection process as this position is deemed to have direct contact with vulnerable persons. Felony convictions, conviction of crimes of moral turpitude, or convictions of misdemeanors related to job duties may disqualify you from being considered for this position. Should your background check reveal any charges or convictions, it is your responsibility to provide the CDHS Background Unit with an official disposition of any charges.
- Former State employees who were disciplinarily terminated or resigned in lieu of termination must (1) disclose that information on the application (2) provide an explanation why the prior termination or resignation should not disqualify the applicant from the current position, (3) provide the employee number from the applicant’s prior State employment. Absent extraordinary circumstances, prior disciplinary termination or resignation in lieu of termination and failure to provide this information will disqualify the applicant from future State employment with CDHS.
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 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.
Supplemental Information
How to Apply
The Assessment Process
For additional recruiting questions, please contact Amber.Holcomb@state.co.us
About Us:
If your goal is to build a career that makes a difference, consider joining the dedicated people of the Colorado Department of Human Services (CDHS). Our professionals strive to design and deliver high quality human and health services that improve the safety, independence, and well-being of the people of Colorado. In addition to a great location and rewarding and meaningful work, we offer:
- Strong, secure, yet flexible retirement benefits including a PERA Defined Benefit Plan or PERA Defined Contribution Planwww.copera.org plus 401(k) and 457 plans
- Medical and dental health plans
- Employer supplemented Health Savings Account
- Paid life insurance
- Short- and long-term disability coverage
- 11 paid holidays per year plus vacation and sick leave
- BenefitHub state employee discount program
- Employee Wellness program
- Excellent work-life programs, such as flexible schedules, training and more
- Remote work arrangements for eligible positions
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.
Our Values:
We believe in a people-first approach: To serve the people of Colorado, we develop a culture and work environment that creates an energized, inspired, and healthy team capable of giving their best to Coloradans.
Balance creates quality of life: We want our team to be resilient through a supportive workplace that values flexibility, health and wellness, and employee engagement.
We hold ourselves accountable: We take responsibility through our actions, programs, and results for the state of health and human services in Colorado.
Transparency matters: We are open and honest with employees, our partners, the Coloradans we serve, and the public.
We are ethical: We abide by what is best for those we serve by doing what is right, not what is easy.
Collaboration helps us rise together: We work together with all partners, employees, and clients to achieve the best outcomes for Coloradans.
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.
ADAA Accommodations: CDHS 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 ADAA Coordinator, Nancy Schmelzer, at cdhs_ada@state.co.us or call 1-800-929-0791.
~THE STATE OF COLORADO IS AN EQUAL OPPORTUNITY EMPLOYER~
~THE STATE OF COLORADO IS AN EQUAL OPPORTUNITY EMPLOYER~
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