Colorado State Eligibility Systems Analyst in Denver Metro, Colorado

Eligibility Systems Analyst



Eligibility Systems Analyst


$3,635.00 Monthly


Denver Metro, CO

Job Type

Full Time


Department of Health Care Policy and Financing

Job Number



3/31/2019 11:59 PM Mountain

  • Description

  • Benefits

  • Questions

Department Information

Health Information Office

Make a difference-Join HCPF by improving health care access and outcomes for the people we serve while demonstrating stewardship of financial resources.

The Department of Health Care Policy and Financing (Department) offers a competitive benefits package to include the Public Employees Retirement Account (PERA), 401k/457, health/dental insurance options, 10 holidays, accrual of paid sick and vacation/annual time, flex place and flex time. The Department is also centrally located; offers affordable ECO passes; has a fitness center on-site; and a variety of discounts on services and products are available to state employees through the State of Colorado's Work-Life Employment Discount Program. The Department also encourages employees to take advantage of advanced education and offers reduced college tuition through CSU Global for their employees. This Department is a "Tobacco Free Workplace".

The Health Information Office develops, implements, and maintains the Department's Health Information Technology (Health IT) and related Information Technology (IT) infrastructure, while coordinating with the Governor's Office of Information Technology and other stakeholders on HIT and IT projects that impact the Department. Major responsibilities of the Health Information Office include enhancing and maintaining the Department's health care claims payment system (Medicaid Management Information System or MMIS) and client eligibility system (Colorado Benefits Management System or CBMS) by developing requirements documentation, reviewing detailed system design approaches, proposing systems solutions to program staff and implementing systems solutions to support Department initiatives. In addition to aligning the Department's infrastructure, this Office creates a foundation for emerging Health IT solutions that will be necessary to implement the Department's transformational vision for the future of Medicaid.

Within the Health Information Office, the Eligibility Systems Section is responsible for system implementations and ongoing system operations regarding a client's eligibility for Medical Assistance Programs. This includes interpreting state and federal regulations concerning eligibility across many categorical assistance programs, ensuring compliance with state and federal regulations and laws for enrolling clients onto Medical Assistance Programs through the PEAK (Program and Eligibility Application Kit) online application tool and Colorado Benefits Management System (CBMS). This is accomplished through research, analysis, written and verbal communication with Medicaid clients, county staff, and eligibility assistance sites. The work unit directs the system implementation of policy and operations into CBMS, the Department's online application tool, and mobile application PEAKHealth.

Description of Job

Under the guidance of the immediate supervisor, the position is an operations and business analyst under the Eligibility Systems Section. Position must have strong working knowledge of Medicaid/CHP+ and the Colorado Benefits Management System (CBMS) and Program Eligibility and Application Kit (PEAK). Position will serve as a resource to the program leads for both PEAK and CBMS and will be relied upon for their knowledge by the Department management, the Department's sister agencies and other external partners and stakeholders in workgroups, steering committees and other internal and external meetings. This includes ensuring that program operations/eligibility systems comply with federal and state laws by working with eligibility policy staff, the Governor's Office of Information Technology (OIT) and the system vendor to implement systems changes. Position will be responsible for communicating system changes and implementation. Position must have excellent written and verbal communication skills to support program business processes, possess technical versatility and creativity to deliver and contribute ideas and solutions. Position may require some instate and overnight travel.

Position works directly with the CBMS and PEAK application to:

  • Resolve case issues through contact with eligibility site technicians and training guidance

  • Research problem cases and offer eligibility site technicians data entry corrections or report possible system issues in CBMS, PEAK and PEAK Health

  • Identify trends and offer solutions and/or produce to resolve the known data entry issues or system issues

  • Assist project leads in medical program system implementation by assisting with the drafting of system requirements, attending system meetings, reviewing system documentation, etc.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights


Education and Experience:

Bachelor's degree from an accredited institution in a field of study related to the work assignment. One year of professional experience in an occupational field related to the work assigned to the position.


Additional appropriate experience will substitute for the degree requirement on a year-for-year basis. Additional appropriate education will substitute for required experience on a year-for-year basis.


Work that 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.


  • Knowledgeable with the CBMS and/or PEAK systems (or similar large IT systems) and performing detailed research in these systems.

  • Professional experience documenting business or functional requirements for large scale eligibility systems (or similar large IT systems) that determined individual's eligibility for medical or financial benefits.

  • Knowledge of how to gather, research and analyze data and produce reports that clearly identify the problem, solution and recommendations based on the findings.

  • Ability to set and prioritize workload, develop a work plan with tasks, time frames, milestones, resources, and dependencies.

  • Strong communication skills, verbal and written.

  • Ability to be self-motivated and self-directed, while possessing the ability to work in a team environment.


  1. All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.

  2. Employees who have been disciplinarily terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.


If you receive notice that you have been eliminated from consideration for the position, you may protest the action by filing an appeal with the State Personnel Board/State

Personnel Director within 10 days from the date you receive notice of the elimination. Also, if you wish to challenge the selection and comparative analysis process, you may file an appeal with the State Personnel Board/State Personnel Director within 10 days from the receipt of notice or knowledge of the action you are challenging. Refer to Chapters 4 and 8 of the State Personnel Board Rules and Personnel Director's Administrative Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel Director's Administrative Procedures are available at

A standard appeal form is available at: If you appeal, your appeal must be submitted in writing on the official appeal form, signed by you or your representative, and received at the following address within 10 days of your receipt of notice or knowledge of the action: Colorado State Personnel Board/State Personnel Director, Attn: Appeals Processing, 1525 Sherman Street, 4th Floor, Denver, CO 80203. Fax: 303-866-5038. Phone: 303-866-3300. The ten-day deadline and these appeal procedures also apply to all charges of discrimination.

Supplemental Information

Address Confidentiality Program:

If you are covered by the Address Confidentiality Program, CRS 24-21-201 through 24-21-214, please notify the HR office or analyst listed on this announcement so that you are provided the appropriate time extension for notifications provided by U.S. mail. The extension allowed under this program applies only to U.S. mail notifications that include a deadline of 10 days or less.

Applications will be reviewed to determine if you meet the minimum qualification for the position. If it is determined that you meet the minimum qualifications, your application will also be used as part of the comparative analysis process to identify a top group for further consideration. Be sure your application specifically addresses the requirements as listed in the minimum qualifications. Address your specialized experience, work products, and accomplishments as they relate to the position duties and minimum and preferred qualifications. Attach additional pages if necessary to fully explain your experience and accomplishments.

Failure to submit properly completed documents by the closing date of this announcement will result in your application being rejected.

Technical Help:

If you experience difficulty in uploading or attaching documents to your online application, call NEOGOV technical support at 877-204-4442 anytime between 6:00 a.m.-6:00 p.m. (Pacific Time). Failure to submit properly completed documents by the closing date of this announcement will result in your application being rejected.

ADAAA Accommodations: Any person with a disability as defined by the ADA Amendments Act of 2008 (ADAAA) may be provided a reasonable accommodation upon request to enable the person to complete an employment assessment. To request an accommodation, please contact by phone or email at least five business days before the assessment date to allow us to evaluate your request and prepare for the accommodation. You may be asked to provide additional information, including medical documentation, regarding functional limitations and type of accommodation needed. Please ensure that you have this information available well in advance of the assessment date