Behavioral Health Parity Analyst (Analyst III): DORA/Division of Insurance

Although this position will be designated under the department’s hybrid workplace program, it will still be required to report to the department office on a scheduled basis and at the discretion of the supervisor, based on business need.  

The Department of Regulatory Agencies (DORA) is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado.

Consumer protection is our mission.

DORA values and promotes diversity, supporting a workplace that is inclusive of people from different backgrounds and experiences; creating an environment that is reflective of our communities; promoting positive relationships; and putting forth unique perspectives to fulfill our mission. 

• Employer-sponsored RTD EcoPass, with offices located at Civic Center Plaza, above the RTD Civic Center station and just a few blocks from RTD light rail. 

• Extensive work-life programs such as flexible schedules, training and professional development opportunities on a wide variety of subjects, and more! 

• Employee wellness programs, including the Colorado State Employee Assistance Program (CSEAP), which provides free, confidential counseling services.

• Bike-to-work programs, including access to storage lockers and bike racks.

• Flexible retirement benefits, including a choice of the PERA Defined Benefit Plan or the PERA Defined Contribution Plan, plus optional 401K and 457 plans.

• Medical and Dental Health Insurance for employees and optional coverage for their dependents.

• Life Insurance for employees, and optional coverage for their dependents.

• Paid Time Off, including 11 paid holidays.

• Short- and long-term disability coverage.

• Tuition assistance program.

The Colorado Division of Insurance (DOI) regulates the insurance industry in Colorado by helping consumers by answering their questions, investigating their complaints, and helping them to understand their insurance.  The Division regulates and monitors the insurance companies in Colorado, as well as insurance agents, ensuring all are following the law. 

Position: SFA 4308

The purpose of this position is to coordinate all logistics of the policy and operational implementation for the division’s behavioral health parity enforcement strategies, pursuant to HB19-1269 and Colorado Insurance Regulation 4-2-64 concerning Mental Health Parity in Health Benefit Plans, and to analyze the quantitative treatment limitations (QTLs) and non-quantitative treatment limitations (NQTLs) data received from carriers in order to fulfill the division’s statutory objectives. The position provides program coordination, data analysis, and administrative support, and it assists with policy analysis for the division’s behavioral health programs to ensure effective and efficient enforcement. 

Duties include, but are not limited to:  

• Serving as lead expert in commercial insurance behavioral health parity compliance, including being responsible for training market regulation, actuarial, and life and health rates and forms teams on data gathering, review, and analysis to determine parity violations and subsequent carrier penalties, consumer refunds, or additional data needed to further determine carrier compliance;
• Coordinating all aspects of the annual submission and review of data by carriers, including monitoring and tracking submissions, organizing and tracking the submissions, and managing the ongoing communications with carriers regarding the division’s expectations for submission quality, deadlines, and other relevant information; 
• Creating data tracking infrastructure to ensure accountability, organization, and efficiency in the division’s requirements to comply with HB19-1269 and enforce mental health parity in health benefit plans;
• Overseeing the analysis of Medical Management Evaluation templates, NQTL Verifications attestations, NQTL Medical/Surgical Questionnaire, NQTL Behavioral Health/Mental Health Questionnaire, NQTL Substance Use Disorder Questionnaire, NQTL Pharmacy Services Questionnaire, NQTL Confidential Network Development Questionnaire, NQTL Network Adequacy template, NQTL Provider Credentialing template, and Network Admission Questionnaire, the American Society of Addiction Medicine Utilization Questionnaire, and Colorado Comparative Analysis Reporting Tool (these templates outline qualitative and quantitative information that illustrate access to care, potential coverage issues, and the cost of behavioral health care compared to physical health care and require a complex and detailed analysis by the position to determine non-compliance and high-level trends in coverage access or barriers);
• Summarizing complicated and detailed policy positions/decisions into approachable, easily understandable information for a variety of audiences, including community partners, insurance carriers, and other policymakers;
• Creating technical assistance and training webinars for carriers as it pertains to annual submission requirements, including developing the training materials, creating and executing an annual schedule of technical assistance and training webinars related to yearly deadlines, communicating such webinars to carriers, and effectively presenting information on webinars;
• Ensuring all DOI personnel involved in MHPAEA compliance processes are aware of and adhere to deadlines, workflows, and other standard operating procedures and policies;
• Developing and maintaining all content and materials for the Mental/Behavioral Health Program website, including supporting implementation of all website updates.

MINIMUM QUALIFICATIONS (MQs):

There are two ways to qualify for this position: 1) Experience OR 2) A Combination of Education and Experience

Option 1: Experience

• Six (6) years of professional* experience working for a healthcare provider, a non-profit health or advocacy organization, in the health insurance industry, in a health policy consulting environment, or for a governmental regulatory entity, performing one (1) of the following three (3) functions:
  • Developing, implementing, or supporting a healthcare policy agenda focused on health insurance access and affordability, including identifying, evaluating and proposing health-related policies, legislation and regulations;
  • Conducting stakeholder outreach and engagement, including building and sustaining relationships with legislators, state agencies, healthcare industry representatives, and state and national interest groups and advocacy organizations. 
  • Conducting studies and analyses of programs or projects through active participation in the planning, coordination, development and/or evaluation to improve behavioral health coverage practices or other health coverage issues (access, antidiscrimination, and/or health coverage disparities).

 

Option 2: A Combination of Education AND Experience 

• Associate’s Degree and Experience: Graduation from an accredited college or university with an associate’s degree in social work, sociology, psychology, statistics, project management, public administration, public health, political science, healthcare administration, healthcare management, law, or in a field of study directly related to the work assignment; AND 
• Four (4) years of professional* experience working for a healthcare provider, a non-profit health or advocacy organization, in the health insurance industry, in a health policy consulting environment, or for a governmental regulatory entity, performing one (1) of the following three (3) functions:
  • Developing, implementing, or supporting a healthcare policy agenda focused on health insurance access and affordability, including identifying, evaluating and proposing health-related policies, legislation and regulations;
  • Conducting stakeholder outreach and engagement, including building and sustaining relationships with legislators, state agencies, healthcare industry representatives, and state and national interest groups and advocacy organizations. 
  • Conducting studies and analyses of programs or projects through active participation in the planning, coordination, development and/or evaluation to improve behavioral health coverage practices or other health coverage issues (access, antidiscrimination, and/or health coverage disparities).

OR

• Bachelor’s Degree and Experience: Graduation from an accredited college or university with a bachelor's degree in social work, sociology, psychology, statistics, project management, public administration, public health, political science, healthcare administration, healthcare management, law, or in a field of study directly related to the work assignment; AND
• Two (2) years of professional* experience working for a healthcare provider, a non-profit health or advocacy organization, in the health insurance industry, in a health policy consulting environment, or for a governmental regulatory entity, performing one (1) of the following three (3) functions:
  • Developing, implementing, or supporting a healthcare policy agenda focused on health insurance access and affordability, including identifying, evaluating and proposing health-related policies, legislation and regulations;
  • Conducting stakeholder outreach and engagement, including building and sustaining relationships with legislators, state agencies, healthcare industry representatives, and state and national interest groups and advocacy organizations. 
  • Conducting studies and analyses of programs or projects through active participation in the planning, coordination, development and/or evaluation to improve behavioral health coverage practices or other health coverage issues (access, antidiscrimination, and/or health coverage disparities).

SUBSTITUTIONS:

• Partial credit toward the degree requirement will be given for completed college/university coursework that did not result in a degree. A master's or doctorate degree from an accredited college or university in a field of study related to the work assignment will substitute for one (1) year of the professional experience. 

*Professional work involves exercising discretion, analytical skill, judgment and 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. 

Document this experience in your application IN DETAIL, as your experience will not be inferred or assumed.  Part time experience will be prorated.

Preferred Qualifications:

• Master’s degree in a field of study directly related to the work assignment;
• Experience making policy decisions/determinations based on data analysis as it relates to healthcare; 
• Experience interpreting or applying stake and federal mental health policy and legislation);
• Experience providing or coordinating provisions of technical assistance related to health equity to agencies to improve culturally-responsive service provision and reduce behavioral health inequities; 
• Experience applying principles, practices and techniques related to health care reimbursement;
• Project management experience, including organizational skills and prioritization and delegating of tasks to other team members; 
• Experience promoting the efficient use of policy and regulatory levers to address barriers and create opportunities to advance healthcare transformation efforts. 

 

Required Competencies: The following knowledge, skills, abilities, and personal characteristics are required competencies and may be considered during the selection process (including examination and/or interview):

• Data and statistical analysis skills;
• Ability to research, analyze and consistently apply state and federal insurance laws, rules, regulations and policies, including interpreting them in order to explain them to various stakeholders;
• Knowledge of the healthcare system, as well as commercial health insurance terminology and subject areas;
• Demonstrated ability to conduct research and gather pertinent information;
• Demonstrated attention to detail;
• Oral communication skills, including the ability to verbally communicate effectively to a diverse audience;
• Written communication skills, including the ability to complete reports in a clear, accurate, and concise manner;
• Ability to analyze systems, processes, procedures, etc. in order to find ways to make them more efficient and effective;
• Demonstrated understanding of how to effectively function in state government, along with the ability to build consensus in a complex and high-pressured, politically-charged environment; 
• Creativity, flexibility, and adaptability with regard to change management, including the ability to adhere to changes in work processes, adapt to changing priorities, and maintain a willingness to comply with and support organizational change(s);
• Demonstrated ability to understand and abide by workplace principles, practices and behaviors as internally identified and defined by the division;
• Ability to represent the department and the Division of Insurance in a positive, professional and objective manner, and support a positive workplace environment;
• Ability to handle sensitive and/or highly confidential information in a professional and ethical manner, and in accordance with state and federal laws;
• Strategic thinking, including the ability to identify emerging issues, anticipate trends, and provide recommendations on strategies to minimize risk impacts; 
• Demonstrated interpersonal skills and the ability to work effectively on collaborative, multi-disciplinary teams;
• Demonstrated time management skills, including the ability to manage competing priorities and meet hard deadlines; 

• Relationship management skills, to establish strong working relationships with stakeholders to ensure collaboration, data exchange, and joint development of performance improvement strategies; 

• Demonstrated understanding of the nation's healthcare programs, their interrelationships, and the social, political and economic forces that affect them;
• Professional demeanor;
• Proficiency in the use of various PC software applications, including Microsoft Office (Word, Excel, etc.), and Google Suite.

Conditions of Employment:Candidates who fail to meet the conditions of employment will be removed from consideration.

• The successful passing of a reference check and/or, if required, a background check.
  • A reference check may include but is not limited to: contacting previous and current supervisors to verify employment and discuss performance, a review of the personnel file, a review of the performance record, a review of job-related public information, etc.
  • The type of background check depends on the job duties of the position, and can include a review of any criminal record, credit report, and/or driving record.
• Ability to travel independently, including work in-office, as required by business need and scheduled by the supervisor.
• Effective September 20, 2021, employees will be required to attest to and verify whether or not they are fully vaccinated for COVID-19. Employees who have not been fully vaccinated may be required to submit to serial testing in the future. Upon hire, new employees will have three (3) business days to provide attestation to their status with proof of vaccination. Vaccinated employees must provide proof of vaccination.
• 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 most recent State of Colorado’s Public Health Order and current guidance issued by the Colorado Department of Public Health & Environment.

Interested individuals must submit the following online:

1. A completed State of Colorado Application (log-in to your current NeoGov account or create a NeoGov account to complete the online application). Note: Incomplete applications, including incomplete work history sections or "see résumé," "see attachment," or "see addendum" statements, will not be accepted in lieu of a completed application form.

2. A current email address on your application, as all communication pertaining to this position will be conducted via email. Please set up your email to accept messages from info@governmentjobs.com and '@state.co.us' addresses, and check your email often. Note: The department cannot guarantee the successful delivery of email, including incorrect filtering into junk mail folders.

3. A detailed cover letter, explaining how you meet the required competencies and how your accomplishments, qualifications, skills, areas of expertise, personal characteristics, etc. make you a good fit for this position; you may also attach additional documents that demonstrate this.

Comparative Analysis Process: Structured Application Review
Part of, if not the entire, comparative analysis process for this position will involve a review of the information you submit in your application materials; Therefore, it is paramount that in the experience portion of your application and cover letter, you describe the extent to which you possess the education, experience, and competencies outlined in the job announcement as well as the required and/or preferred qualifications/competencies. You are also encouraged to attach additional documents to that effect. Failure to include adequate information or follow instructions may affect your score and prevent you from competing in subsequent measures used to arrive at a top group of applicants.

Veterans' Preference: Candidates who wish to assert Veterans' Preference should attach a copy of their DD-214 to their application. Failure to do so will result in being denied Veterans Preference.

PLEASE NOTE: Former State Personnel System employees who were disciplinarily terminated or resigned in lieu of termination must disclose this information on the application.  Colorado Revised Statutes require that all state employees be hired and promoted through competitive examination of merit and fitness.  Failure to include the required information, failure to follow instructions, and/or failure to submit materials by the application deadline may result in your application not being considered for the position and may affect your score or inclusion in the final pool of qualified candidates.

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.

DORA 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, Rachael Alkayali, at dora_hr@state.co.us or call (303) 894-2441.

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, US Mail, faxed or hand-delivered within ten (10) calendar days from your receipt of notice or acknowledgment 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 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.   

Salary : $4,809 - $6,250