Work Requirements Eligibility Operations Analyst

Department Information
State Of Colorado Residency Required At Time Of Application
*Due to the State's current hiring freeze, this position will not be filled until after January 1, 2026.
NOTE: This announcement may be used to fill multiple openings. *
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.

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 looking for a Work Requirements Eligibility Operations Analyst to join our Eligibility Operations 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)
• 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 more information, go to .

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.

**Please note - equipment provisioning and certain onboarding tasks will take place in person, in our downtown Denver office, on the first day of employment.**

Description Of Job
This position is the Department's Staff Authority for Eligibility Operations related to Medicaid Work Requirements. The position designs and directs the business processes, operational guidelines, and data standards that govern how Colorado implements and monitors Medicaid Work Requirements.

Typical Duties Include, But Are Not Limited To

• Lead the development of statewide business process standards, decision trees, and verification frameworks for determining member compliance or exemption for Medicaid Work Requirements.
• Collaborate with eligibility policy and systems teams to translate federal and state policy into operational procedures for the Colorado Benefits Management System (CBMS), Program Eligibility and Application Kit (PEAK), and county eligibility workflow ensuring management receives the guidance needed to lead teams through policy changes and operational updates.
• Work directly with eligibility workers and supervisors to define, document, and validate real-world eligibility workflows, pain points, and process improvements, including engaging eligibility workers as co-design partners to ensure procedures are practical, consistent, and compliant.
• Collaborate in the development of eligibility performance metrics and advise on corrective action plans when data trends indicate risk to federal compliance or member access.
• Coordinate with the Eligibility Audits Team, the Partner Relations & Administration Division, the Fraud/Waste/Abuse Division, the External Audits Section, and other operational areas to align reporting and audit methods.
• Lead eligibility operations engagement with eligibility sites and external partners to coordinate Medicaid Work Requirements implementation.
• Partner with the Staff Development Division lead and Eligibility Lead Trainer to co-develop training, desk aids, and communication materials that reflect actual case-processing steps for eligibility workers.
• Performs other duties as assigned.

Residency Requirement
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
This posting is only open to residents of the State of Colorado at the time of submitting your application.

Class Code & Classification Description
H1C4XX ANALYST IV

Minimum Qualifications
Experience Only:
Seven (7) years of related professional experience working in Colorado Benefits Management System (CBMS) to determine eligibility for Medicaid and CHP+.

OR
Education And Experience
A bachelors degree from an accredited institution in a related field and three (3) years of professional experience working in Colorado Benefits Management System (CBMS) to determine eligibility for Medicaid and CHP+ .

Appropriate education will substitute for the required experience on a year-for-year basis. Relevant education will be calculated as the following:

• An associate will count as two years of experience
• A bachelors will count as four years of experience
• A masters degree will count for six years of experience
• A doctorate or juris doctorate degree will count for seven years of experience
• Note: Per the Job Application Fairness Act , you may redact information that identifies your age, date of birth, or dates of attendance at or graduation from an educational institution on your transcripts.

Preferred Qualifications

• Prior state experience related to the duties of this position OR
• Experience working with Medicaid and CHP+ policies and programs
• Experience with monitoring and oversight of public assistance programs, including the ability to conduct audits or reviews ensuring program compliance
• Experience communicating with internal and external stakeholders
• Experience implementing system changes related to operational improvements

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.
• May be required to travel occasionally for county or stakeholder engagement

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.

Appeal Rights
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.

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.

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 within ten (10) calendar days from your receipt of notice or acknowledgement of the Department's action.

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 .

Supplemental Information
How to Apply
(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 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.
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.

Comparative Analysis Process
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.

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 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.

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 .

The Department of Health Care Policy & Financing
does not
offer sponsored visas for employment purposes.