Were with you for lifes journey. At Denver Health purpose isnt just something we believe inits something we live every day for lifes journey.

Our Values

Respect Belonging Accountability Transparency

Department

* This is a hybrid role with a weekly in-office requirement.

Job Summary

Assists the Commercial Products team with the maintenance and administration of the Denver Health Medical Plan Inc. (DHMP) Exchange including CO Option and Employer Group products. This position will ensure compliance with all State and Federal-level regulatory requirements requiring strong attention to detail and the ability to independently research interpret and apply regulatory guidance. Standard work also includes creating analyses and reports assisting with project and implementation plans developing marketing materials and providing input on policies and procedures for departmental activities. This position will routinely utilize multiple systems and data sources to complete work timely and accurately as well as interact with all levels of management and employees plan members external consultants and State and Federal representatives.

Essential Functions:

• Reviews all State and Federal regulations and policy changes conducting independent research to understand regulatory intent and operational impact; then communicates and collaborates with program areas to support implementation. Supports in analysis and coordination of internal and regulatory audits and regulatory materials (handbooks benefit information) and communications. Supports member experience through attending events and partnering with the Marketing team to ensure aligned messaging to educate and retain members. (30%)
• Works independently with Commercial Products team and other Managed Care Departments serving as liaison to interpret contractual or regulatory requirements leading the effort to improve workflows policies and procedures. Creates and compiles accurate and vetted reports attestations and other submissions to the State and CMS. Sustains collaborative relationships and promotes meaningful dialogue with regulatory bodies internal teams and community partners. (30%)
• Researches and resolves member and provider escalations requiring familiarity with Commercial health insurance benefits and ACA/Exchange products (20%)
• Assists in setting strategic direction of projects developing project plans analytic support services and applicable technical/subject matter expertise to achieve organizational goals. (20%)

Education:

• Bachelors degree required

Work Experience:

• Less than 1 year of health care/plan experience with a preferred emphasis on Commercial health plan operations regulatory issues policy development or compliance required

Licenses:
Knowledge Skills and Abilities:

• Substantial knowledge of managed care/health care administration policy and compliance particularly regarding Commercial health plan operations
• Ability to interpret and synthesize Federal and State regulatory requirements
• Proficiency in Microsoft Excel including pivot tables VLOOKUP and other functions to analyze reconcile and validate datasets
• Self-starter who works with limited supervision and guidance demonstrating strong organizational skills and attention to detail
• Ability to define problems collect data establish facts and draw valid conclusions to implement solutions and ability to develop data requirements and work with operations teams and groups to extract organize and analyze data and trends
• Critical thinking strong written and verbal communication skills and the ability to work collaboratively in groups
• Ability to work on multifaceted projects in conjunction with day-to-day activities
• Critical thinking strong written and verbal communication skills and the ability to work collaboratively in groups

Shift

Work Type

Salary

Benefits

At Denver Health we take care of the people who take care of our community. Our benefits are built to support your life your family and your future with generous paid time off fully paid parental leave exceptional retirement contributions comprehensive health coverage and nationally recognized well-being programs. We invest in your growth through tuition assistance career advancement pathways and professional development while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health youre joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

• Paid time off starting at 28 days per year inclusive of vacation personal/sick and 7 Holidays

• 100% paid parental leave up to 6 weeks

• Immediate eligibility for retirement plans with employer contribution up to 9.5%

• Generous medical dental vision plans in addition to employer paid disability and life insurance.

• Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center

• Free RTD EcoPass (public transportation)

• Childcare discount programs & exclusive perks on large brands travel and more

• Tuition reimbursement & assistance

• Education coaching and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways

• Professional clinical advancement program & shared governance

• Public Service Loan Forgiveness (PSLF) eligible employer free student loan coaching and assistance navigating the PSLF program

• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health

Denver Health is an integrated high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center a 555-bed acute care medical center Denvers 911 emergency medical response system 10 family health centers 19 school-based health centers Rocky Mountain Poison & Drug Safety the Public Health Institute at Denver Health Denver Health Medical Plan and Denver Health Foundation.

As Colorados primary and essential safety-net health care system Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.

Located near downtown Denver Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test once a conditional offer of employment has been made. Applicants will be considered until the position is filled.