Job Description
JOB STATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION
This is a term limited position funded until 6/30/2028. NOTE:
This announcement may be used to fill multiple openings. Envision Yourself Working at HCPF 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 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. 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 Reduced college tuition through CSU Global Credit Union of Colorado Membership Eligibility 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 We are looking for a HCBS-Developmental Disabilities (DD) Waiver Enrollment & Appeals Specialist TERM LIMITED
for the Office of Community Living! The Benefits and Services Management Division (BSMD) exists as part of the Department of Health Care Policy and Financing (HCPF), which is the federally recognized single state agency to administer the Colorado Medicaid program of health care coverage for persons who qualify. The BSM Division administers the state's long term care programs such as nursing facility, hospital backup, and community long term care programs such as Home and Community Based Services (HCBS) waiver programs. The division provides oversight and monitoring for the state's single entry point system for access to the state's long term care programs, including those administered by the Department and those administered under agreement with the Department of Human Services (DHS). Staff within the Division are responsible for stakeholder relations, policy development and implementation, contract management and performance, program administration and overall Long Term Services and Support Medicaid program performance. The Division plays an important role in working towards the Department's mission to improve access to cost-effective, quality long term care services and supports for Coloradans. 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.•EXAMPLE OF DUTIES
Position Summary The Policy and Operations Specialist serves as the Office of Community Living's recognized expert on HCBS Developmental Disabilities (HCBS-DD) waiver enrollment policy, Emergency Enrollment Request (EER) determinations, youth transitions, and HCBS/Community First Choice (CFC) appeals operations. This position independently interprets federal Medicaid regulations, state statutes, State Board rules, and waiver requirements to ensure consistent, equitable, and compliant statewide administration of enrollment and appeals processes. The position provides strategic policy leadership and expert consultation to Department leadership, Case Management Agencies (CMAs), internal program teams, and external stakeholders regarding complex enrollment and appeals issues. As the Department's primary authority on EER determinations and appeals policy, this position establishes statewide policy interpretations, develops decision-making frameworks, identifies systemic program risks, and recommends policy and operational improvements that directly influence rulemaking, legislative analysis, waiver administration, and long-term Medicaid sustainability. Decisions and recommendations made by this position have significant statewide implications for federal compliance, budget management, program integrity, and equitable access to services. Key Responsibilities HCBS-DD Waiver Enrollment and Emergency Enrollment Requests (EER) Serve as the Department's primary expert and reviewer for Emergency Enrollment Requests (EERs) within the HCBS-DD waiver program. Develop and maintain statewide policy interpretations, decision frameworks, and operational guidance related to HCBS-DD waiver enrollment and emergency access to services. Apply federal regulations, state statutes, waiver requirements, and Department policy to determine eligibility for enrollment and EER approval. Ensure consistency, equity, and compliance in enrollment determinations across all Case Management Agencies (CMAs). Review, approve, deny, and communicate EER determinations and resolve disagreements regarding enrollment decisions. Identify policy gaps, determine when existing policy requires clarification or revision, and recommend changes to leadership. Provide policy guidance, technical assistance, and operational support to CMAs regarding enrollment processes, youth transitions, and waiver requirements. Analyze enrollment and EER data, identify trends, and prepare reports and recommendations to improve statewide processes and outcomes. HCBS Waiver Appeals Administration Manage and coordinate HCBS waiver and Community First Choice (CFC) appeals activities across the Department and external stakeholders. Provide authoritative interpretation of appeals-related federal guidance, state statutes, State Board rules, and Department policies. Monitor appeal timelines and ensure compliance with regulatory requirements and established deadlines. Coordinate with CMAs, Department program staff, and the Office of Legal Services regarding appeals status, outcomes, and resolution strategies. Develop and maintain tracking systems for appeals and generate reports to identify trends, risks, and opportunities for improvement. Analyze appeal outcomes to identify systemic issues and recommend policy, operational, or training enhancements. Policy Development and Strategic Leadership Independently interpret complex federal and state requirements and develop policy recommendations that influence statewide enrollment and appeals practices. Advise Department leadership on programmatic impacts, compliance risks, operational challenges, and long-term sustainability strategies. Support Department rulemaking, legislative analysis, and policy development efforts related to HCBS waiver programs. Identify and evaluate systemic issues affecting program access, compliance, and operational effectiveness, and recommend corrective actions. Develop guidance, procedures, and training materials to support consistent statewide implementation of policy. Stakeholder Engagement and Collaboration Serve as the primary policy resource for CMAs, internal Department teams, advocacy organizations, and other external partners. Collaborate with stakeholders to clarify policy intent, resolve complex issues, and improve program operations. Represent the Department in discussions, negotiations, and workgroups involving enrollment policy, appeals operations, and HCBS waiver administration. Foster statewide consistency and alignment in policy implementation and operational practices. Program Oversight and Compliance Ensure enrollment and appeals processes comply with federal waiver assurances, the 1915(c) waiver agreement, state requirements, and Department standards. Monitor statewide practices and identify compliance vulnerabilities, operational risks, and opportunities for process improvement. Exercise independent judgment on highly complex issues with significant statewide programmatic, fiscal, legal, and compliance implications. Provide recommendations that support equitable access to services, program integrity, and long-term Medicaid sustainability. 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, Anupreet Kaur, at anupreet.kaur@state.co.us. The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes.
