Financial Compliance SpecialistPrint (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4534294) ApplyFinancial Compliance SpecialistSalary$57,708.00 - $75,024.00 AnnuallyLocation Denver Metro, COJob TypeFull TimeJob NumberUHA04507-06-2024DepartmentDepartment of Health Care Policy and FinancingDivisionCommunity Living OfficeOpening Date06/06/2024Closing Date6/23/2024 11:59 PM MountainFLSADetermined by PositionType of AnnouncementThis position is open only to Colorado state residents.Primary Physical Work Address303 E 17th Ave Denver, CO 80203 (Position is Hybrid)FLSA StatusExempt; position is not eligible for overtime compensation.Department Contact InformationSarah Roman, Talent Acquisition Specialist [email protected] To ApplyPlease submit an online application for this position at https://www.governmentjobs.com/careers/colorado. Reach out to the Department Contact to apply using a paper application, including any supplemental questions. Failure to submit a complete and timely application may result in the rejection of your application. Applicants are responsible for ensuring that application materials are received by the appropriate Human Resources office before the closing date and time listed.
Description
Benefits
Questions
Department InformationSTATE OF COLORADO RESIDENCY REQUIRED AT TIME OF APPLICATION NOTE: This announcement may be used to fill multiple openings. 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. We are looking for aFinancial Compliance Specialist to join ourOperations and Administration Divisionin theOffice of Community Living ! As part of the State of Colorado, HCPF offers a competitive benefits package: (https://dhr.colorado.gov/state-employees/state-of-colorado-employee-benefits)
PERA retirement benefits including PERA Defined Benefit Plan, PERA Defined Contribution Plan, plus 401K and 457 plans
Medical (https://dhr.colorado.gov/state-employees/state-employee-benefits/medical-benefits) , Dental (https://dhr.colorado.gov/state-employees/state-employee-benefits/dental-insurance) , and Vision (https://dhr.colorado.gov/state-employees/state-employee-benefits/vision-insurance) insurance coverage
Automatic Short-Term and Optional Long-Term Disability Coverage (https://dhr.colorado.gov/state-employees/state-employee-benefits/disability-insurance)
Life and AD&D Insurance
Flexible Spending Accounts (https://dhr.colorado.gov/state-employees/state-employee-benefits/flexible-spending-accounts) (FSAs)
Family Medical Leave Act (FMLA) (https://dhr.colorado.gov/state-employees/time-off-leave/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 (https://dhr.colorado.gov/state-employees/time-off-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 (https://www.rtd-denver.com/fares-passes/ecopass) to all eligible State Employees
Credit Union of Colorado (https://www.cuofco.org/credit-union-colorado-membership-eligibility) 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 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.
Information about the Operations and Administration Division:The Operations and Administration Division (Division) within the Office of Community Living (Office) acts as the service and support entity of the Office. The Division includes financial oversight, contract management, administrative support, and systems support for the day to day activities of the Office. The Financial Compliance & Monitoring Section within the Operations and Administration Division oversees the Case Management Agency (CMA) contracts and budgets totaling approximately $70 million annually; financial and contractual reviews of the CMAs that include the Family Support Services Program, State Supported Living Services Program, and OBRA Specialized Services Program; subrecipient monitoring activities for CMAs; and financial compliance reviews and recoveries for nursing facility providers, service providers, and case management agencies. The Financial Compliance Unit is within the Financial Compliance & Monitoring Section of the Division.Description of JobWhat you'll be doing:
This position, in coordination with similar positions, completes compliance reviews of approximately 900 Home and Community Based Services (HCBS) service providers.
Conducts ongoing compliance reviews of providers to ensure direct care workers and independent contractors for specific HCBS waiver services are compensated at a specific hourly base wage established by the Department.
Reviews accounting records maintained by service providers specific to the base wage compliance requirements to ensure regulatory compliance.
Requests documentation from service providers; reviews the records; and makes a determination on compliance.
Issues a determination letter, reviews, and responds to all contested non-compliance determinations.
Requests a corrective action plan from the service provider and reviews their response. Approves or rejects the corrective action plan.
Issues a demand letter for recovery of Medicaid dollars pursuant to C.R.S. 25.5-4-301. Which includes researching and responding to all informal reconsiderations and/or appeals submitted by the service providers, if necessary.
Prepares and represents the Financial Compliance Unit (Unit) during any informal reconsiderations or appeals of recoveries from service providers.
Presents to Unit Supervisor or designee any non-compliance issues and recommends program improvements.
Ensures all reviews comply with all applicable Generally Accepted Government Auditing Standards (GAGAS) and Generally Accepted Accounting Principles (GAAP).
Responsible for following review plans, programs, procedures, and utilizing review templates to complete the base wage compliance reviews conducted by the Unit.
Assists in drafting and revising the review scope; maintaining and updating internal review procedures; and developing and revising review templates and tools.
Ensures that the review scope and tests meet all federal, state and Department regulations. Also ensures that the review scope is modified to meet any changes in regulations.
Works with team members in developing program policy and ensuring system changes are incorporated into the review process.
Uses their expertise in conducting compliance reviews to recommend approaches and best practices for other Unit staff.
Position communicates verbally and in writing with Department staff and Medicaid providers.
Conducts other compliance reviews as assigned to include nursing facility compliance reviews, personal needs account reviews, case management agency compliance reviews, etc.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal RightsResidency Requirement: This posting is only open to residents of the State of Colorado at the time of submitting your application. MINIMUM QUALIFICATIONS:There are two ways to qualify for this position:Option 1:Experience Only: Six (6) years of relevant experience related to conducting financial audits or other similar compliance activities.Option 2:Education and Experience: A bachelor's degree from an accredited institution in a related field and two (2) years of relevant experience related to conducting financial audits or other similar compliance activities.Appropriate education will substitute for the required experience on a year-for-year basis. Relevant education will be calculated as the following:
An associates 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
PREFERRED QUALIFICATIONS:
Prior state experience related to the duties of this position
Intermediate Microsoft Excel skills
Intermediate understanding of audit principles and standards
Experience conducting financial or programmatic audits for Medicaid or Long Term Care programs
Experience with Medicaid billing or reimbursement structure
Experience creating, developing, or updating tracking and auditing tools based on regulation changes and/or process changes
Highly Desired Knowledge, Skills and Abilities:
Strong attention to detail that will be used when conducting financial reviews to verify providers are paying the appropriate wage or billing Medicaid appropriately.
Ability to work independently to review supporting documentation and work in spreadsheets for most of your workday.
Ability to think critically about unique situations that arise during an audit to include problem-solving the issue, drafting non-standard responses to audit findings, developing new processes for reviewing documentation, or creating new calculations.
Strong organizational skills that will be used to keep track of different audits that may be in various statuses at any given time and with varying priority levels.
Strong communication skills (both oral and written, and interpersonal skills) in order to work effectively with providers, stakeholders and coworkers.
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.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.
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 [email protected] 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 spb.colorado.gov/board-rules .
Supplemental InformationHow to Apply (https://careers.colorado.gov/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, Virginia Miller, at [email protected] ([email protected]) . The Department of Health Care Policy & Financing does not offer sponsored visas for employment purposes. The State of Colorado offers permanent employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for detailed information: www.colorado.gov/pacific/dhr/benefits Please note that each agency's contact information is different; therefore, we encourage all applicants to view the full, official job announcement which includes contact information and class title. Select the job you wish to view, then click on the "Print" icon.01 All HCPF positions are security-sensitive positions and require potential employees to undergo a criminal record background check. As a condition of employment, you will be required to submit to pre-employment screening if offered the position. Are you willing to meet this requirement?
Yes
No
02
Do you have any relatives or significant others working at the Department of Health Care Policy & Financing? If so, please list their names here. Otherwise, please list N/A.
03
If you are a current or former State of Colorado employee, please provide your EID (employee identification numbers will start with 99). If not, please type N/A.
04
Are you willing to accept an offer within the posted salary range?
Yes
No
05
Former state employees who were disciplinarily terminated or resigned in lieu of termination must disclose the information on the application. In the space below, please provide an explanation as to why the prior termination or resignation should NOT disqualify your application from the current position. Otherwise, please list N/A.
06
Describe a time when you had to think outside the box during the course of an audit or other compliance task.
07
Describe a time when you presented an idea to your supervisor that helped improve a process performed by the team.
08
List any additional relevant experience you would like us to consider in determining if you meet the qualifications of this position. Please, include the months and years relevant to the experience you describe.
Required Question
AgencyState of ColoradoAddressSee the full announcement by clickingthe "Printer" icon located above the job titleLocation varies by announcement, Colorado, Websitehttps://careers.colorado.gov/ApplyPlease verify your email addressVerify Email