Medicaid Enterprise System Test Analyst

State of Colorado; Denver (CO); Hybrid; USD 80,000 - 100,000; Full time

Job summary

State of Colorado is seeking a Medicaid Enterprise System Test Analyst for the Contracts & Quality Assurance Division within the Health Information Office (HIO). The role focuses on quality assurance and testing for CMES to ensure accurate processing and payment for Health First Colorado, CHP+, and related programs.

The position involves developing test strategies, creating test data, validating interfaces, managing test cycles, and coordinating with vendors and program staff in a hybrid work

Qualifications

• Six total years of professional experience in software testing for complex IT systems.
• Bachelor's degree from an accredited institution in Business, Computer Science, IT, or related field and two total years of professional experience in software testing for complex IT systems. Education substitutes for experience on a year-for-year basis.

Responsibilities

• Reviews requirements, design documents, release notes and criteria to identify test scope and risks for CMES modules.
• Develops risk-based test strategies, scenarios, and test cases for functional, integration, end-to-end and regression testing.
• Identifies test data representing claims, eligibility, enrollment, and other CMIS transactions used for verification.
• Executes test cases across interChange/MMIS and CMES modules and tracks results in the test repository.

Skills

Communication skills

Teamwork

Education

Associates degree

Bachelor's degree

Masters degree

Doctorate or Juris Doctorate

Tools

Jama software

Job description

State of Colorado Residency Required at Time of Application

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.

About the Department

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.

Position Summary

We are looking for a Medicaid Enterprise System Test Analyst for the Contracts & Quality Assurance Division of the Health Information Office (HIO)! The Contracts & Quality Assurance Division in HIO manages quality assurance and testing for the Colorado Medicaid Enterprise Solutions (CMES) ecosystem to help ensure timely, accurate processing and payment for Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus (CHP+), Behavioral Health Administration (BHA)-related services, and other covered programs in an environment of rapid policy and system change. The unit supports program management for Health First Colorado and related programs with a multi-billion-dollar annual budget. The work unit researches, verifies, and validates CMES modules and subsystems; evaluates project requests; develops test scenarios and test cases; and executes testing throughout the software development life cycle. The work unit coordinates with internal and external stakeholders, the MMIS/interChange vendor, CMES module vendors, and Department program and business analyst work units to deliver high-quality, compliant changes that meet program policies. The work unit also supports state and federal audits of Department systems and programs related to claims reimbursement, provider enrollment, and benefits coverage.

Job Description

• Reviews approved business requirements, system requirements, change requests, design documents, interface specifications, release notes, and acceptance criteria to identify test scope, dependencies, risks, and expected results for Colorado interChange and other CMES modules.
• Develops risk-based test strategies, scenarios, test cases, scripts, and expected results for functional, user acceptance, regression, integration, interface, end-to-end, negative, and error-handling testing.
• Identifies and prepares test data representing claims, encounters, providers, members, eligibility, benefits, capitation, reference data, and other transactions needed to verify system behavior.
• Maintains requirements-to-test traceability and confirms that each approved requirement and identified risk is covered by one or more test cases.
• Executes approved test cases for Colorado interChange/MMIS and related CMES modules, including PBMS, DSS/BIDM, CBMS, and connected interfaces, using functional, user acceptance, regression, integration, end-to-end, and smoke testing methods.
• Verifies system calculations, claims adjudication and pricing, eligibility and enrollment, provider data, capitation, file processing, reports, notices, batch jobs, and other outputs against documented expected results.
• Captures complete test evidence, including transaction identifiers, screenshots, input and output files, control totals, queries, reports, logs, and actual results, and records pass, fail, blocked, or not-run status in the approved test repository.
• Serves as a testing subject matter expert for inbound and outbound interfaces among Colorado interChange/MMIS, PBMS, DSS/BIDM, CBMS, and other CMES modules; validates file layouts, data mappings, acknowledgments, control totals, error handling, timing, and end-to-end reconciliation.
• Coordinates assigned test cycles with program staff, business analysts, system analysts, vendors, and other testers; confirms environments, builds, access, data, dependencies, schedules, and defect turnaround.
• Selects and executes regression suites for monthly releases, change orders, emergency fixes, and vendor upgrades to verify that unchanged functions continue to operate as expected.

Minimum Qualifications & Eligibility

This posting is only open to residents of the State of Colorado at the time of submitting your application.

Class Code & Classification Description

H1C3XX Analyst III

Minimum Qualifications

Option 1: Six (6) total years of professional experience in software testing for complex IT systems.

Option 2: Bachelor's degree from an accredited institution in Business, Computer Science, IT, or a related field and two (2) total years of professional experience in software testing for complex IT systems. 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

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

• Previous relevant professional state experience
• Masters degree in Business, Health Care Administration, or a related field
• Professional experience with:
  • State Medicaid software
  • Writing and executing test cases
  • Jama software

Skills To Support Success

• Communication skills across internal and external stakeholder teams
• Teamwork

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 [e-mail] within ten (10) calendar days from your receipt of notice or acknowledgment 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.

Benefits

• 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

Work Arrangements

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.

Equipment Provisioning

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

Compensation Policy

Per the requirements of the Step Pay Program implemented on July 1, 2024, any State employee must be paid a rate that is equal to or greater than the appropriate step pay rate within their classification’s pay range based on completed years in their current class series as of June 30. All current and former State employees must ensure that your entire work history within the State Classified System, including at Institutions of Higher Education, is indicated in your application so that your time-in-series can be calculated accurately. Please verify that this information is included in your application in the supplemental questions.

Visa Sponsorship

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