Enterprise Solutions Integration (ESI) Business Analyst

• Serves as the Department’s business and systems authority for Colorado Medicaid Enterprise System (CMES) data exchanges, data & interface design, and integration across the medicaid ecosystem, ensuring medicaid policy are correctly operationalized in technical solutions supporting Medicaid and HR1 Medicaid Work Requirements compliance.
• Applies knowledge of Medicaid & CHP+ operations, CMES integration and eligibility systems, MITA 3.0 standards, and CMS guidance to translate policy and operational requirements into clear business, functional, system, and interface requirements, validating that proposed technical solutions correctly implement business intent within CBMS and the broader Medicaid Enterprise.
• Leads the business and system design for interfaces supporting ex parte and verification processes, defining when, why, and how interface & integration systems exchange are necessary to support accurate eligibility determinations. Reviews and validates functional and technical design documents to ensure traceability to approved business requirements and alignment with policy intent prior to implementation.
• Leads requirements elicitation and review activities, including business process mapping, functional specifications, interface requirements, and testing artifacts, serving as the primary interpreter between policy, operations, and technical teams to ensure alignment with policy intent, system architecture, and SDLC governance standards within the scope of HR1 work requirements.
• Works with policy and eligibility operations teams to confirm functional specifications reflect the intent of Medicaid Work Requirements system requirements.
• Directs contractors through the SDLC and governance processes by setting expectations for requirements quality, system design decisions, data flows, and configuration standards, reviewing deliverables for business correctness, system integrity, and operational feasibility.
• Collaborates with contractors, state agencies, federal entities, and private-sector partners to establish secure APIs and batch interfaces for employment, education, and service verification.
• Supports the full testing lifecycle in collaboration with stakeholders and contractors, including System Integration Testing (SIT), End-to-End (E2E) testing, and User Acceptance Testing (UAT), as well as post-implementation validation, ensuring test scenarios and results validate system functionality and integrations with traceability to approved requirements.
• Serves as a Business Analyst and Systems Integration liaison for Work Requirements implementation, representing ESI in cross-organizational discussions on , requirements interpretation, and interface design with CBMS, OIT, vendors, CMS, and other stakeholders as appropriate.
• Provides SDLC and integration governance consultation to policy and operations teams on feasibility, risks, and resource impacts of proposed system changes.

• Leads integration technical briefings and readiness reviews with executive leadership, CMS representatives, and stakeholders as needed., 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 dpa_state.personnelboard@state.co.us 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.

We are looking for an Enterprise Solutions Integration (ESI) Business Analyst for the ESI Division of the Health Information Office (HIO)!, Seven (7) total years of professional experience managing business processes and vendors, conducting business analysis, and leading the Software Development Lifecycle (SDLC) for large, complex healthcare systems., Bachelor’s degree from an accredited institution in Health Care Administration, Business Administration, or a related field AND Three (3) total years of professional experience managing business processes and vendors, conducting business analysis, and leading the Software Development Lifecycle (SDLC) for large, complex healthcare 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, * Previous relevant professional state experience
• Masters degree in a relevant field
• Professional experience in:
• Serving as a Systems Business Analyst leveraging a formal SDLC methodology.
• Working as an analyst in a large Medicaid, Eligibility or Pharmacy benefits claims processing ecosystems.
• Contributing to large-scale enterprise system implementations within regulated healthcare environments.

Skills to Support Success

• Ability to translate health care policy into business requirements
• Commitment to keeping promises and meeting deadlines
• Work in a team environment remotely and in-person developing relationships across an organization that promote innovation and collaboration
• Flexible, must be able to lead meetings and take direction at the same time
• Ability to communicate technical details to a non-technical audience

Pulled from the full job description

• Flextime
• Loan forgiveness
• AD&D insurance
• 401(k)
• Health insurance
• Employee discount

• Vision insurance, The ESI Division of HIO manages the design, integration, and certification of all systems and interfaces within Colorado’s Medicaid Enterprise System (CMES). The Division ensures interoperability, data accuracy, and federal compliance across all CMES modules including eligibility, claims, provider, and analytics processes. ESI implements technology solutions supporting new CMS policy mandates, including Medicaid Work Requirements, to ensure the Department’s programs remain compliant, efficient, and member-focused. The work section is responsible for researching, eliciting, verifying and validating the transmission of data and integration functions and processes through the Enterprise Solutions Integration Platform and across the CMES ecosystem. This unit enforces data and integration governance processes by utilizing the Software Development Life Cycle (SDLC) methodologies and integration industry best practices to ensure consistency with all Module Vendors across the CMES ecosystem. 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 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.

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