| Location | Denver, CO |
Complex Interactions Specialist (Administrator III) - DORA: Division of Insurance
Salary
$4,955.00 - $6,439.00 Monthly
Location
Denver, CO
Job Type
Full Time
Job Number
SFA-64165-10/2026
Department
Department of Regulatory Agencies
Division
Division of Insurance
Opening Date
10/01/2026
Closing Date
10/9/2026 11:59 PM Mountain
FLSA
Determined by Position
Type of Announcement
This position is open only to Colorado state residents.
Primary Physical Work Address
1560 Broadway, Denver, CO 80202
Department Contact Information
Thanh Pham: thanh.pham@state.co.us
How To Apply
Please 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.
Department Information
Hybrid Workplace Arrangement:
Although this position will be designated under the department's hybrid workplace program, it will still be required to report to the department office on a scheduled basis and at the discretion of the supervisor, based on business needs.
This announcement may be used to fill multiple vacancies.
The Department of Regulatory Agencies (DORA) is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado.
Consumer protection is our mission.
DORA values and promotes diversity, supporting a workplace that is inclusive of people from different backgrounds and experiences; creating an environment that is reflective of our communities; promoting positive relationships; and putting forth unique perspectives to fulfill our mission.
Employer-sponsored RTD EcoPass, with offices located at Civic Center Plaza, above the RTD Civic Center station and just a few blocks from RTD light rail.
Extensive work-life programs such as flexible schedules, training and professional development opportunities on a wide variety of subjects, and more!
Employee wellness programs, including the Colorado State Employee Assistance Program (CSEAP), which provides free, confidential counseling services.
Bike-to-work programs, including access to storage lockers and bike racks.
Flexible retirement benefits, including a choice of the PERA Defined Benefit Plan or the PERA Defined Contribution Plan, plus optional 401K and 457 plans.
Medical and Dental Health Insurance for employees and optional coverage for their dependents.
Life Insurance for employees, and optional coverage for their dependents.
Paid Time Off, including 11 paid holidays.
Short- and long-term disability coverage.
Tuition assistance program.
Check out our excellent benefits package!
Description of Job
The Colorado Division of Insurance (DOI) regulates the insurance industry in Colorado. The DOI helps consumers by answering their questions, investigating their complaints, and helping them to understand their insurance. The DOI regulates and monitors the insurance companies in Colorado and insurance agents to ensure everyone follows the law.
The Senior Medicare Patrol (SMP) is a national program funded by the U.S. Department of Health and Human Services, Administration for Community Living (HHS/ACL) through a federal grant on an annual funding cycle beginning of June of each year. Under this grant, this work unit, the Colorado SMP program is tasked with providing Medicare fraud education and responding to fraud and abuse allegations reported directly by consumers or referred by agencies throughout the state. The outreach and education portion of the program is conducted primarily by fifteen (15) sub-grantee agencies consisting of Area Agencies on Aging, volunteer programs, community agencies, and non-profit organizations around the state which the Senior Health Unit at the Division of Insurance in DORA oversees. The complaint investigation function is centralized in the state, additionally, referrals for further investigation and enforcement are made to appropriate federal and/or state partners. As such, protection of vulnerable consumers is a core component of the SMP, as is eliciting the involvement of volunteers and other SMP team members at the local sub-grantee agencies to help educate beneficiaries and their caregivers on how to prevent, detect, and report Medicare fraud, abuse, and errors.
Position: SFA 64165
This position exists to investigate and assess consumer and other reports of suspected fraud, abuse, or error by Medicare healthcare providers or marketing agents and refer cases for federal or state enforcement actions as appropriate. This position focuses on SMP in the Senior Health (SHIP/SMP/MIPPA Programs) work unit. The position mentors and supports work done by the sub-grantee agency consisting of Area Agencies on Aging, volunteer programs, and community action agencies personnel, and volunteers in the identifications and reporting of suspected Medicare fraud; handles basic information gathering for cases, and refers more complex cases and questions. This position shares responsibility with the SMP Program Manager for managing database entries in the online reporting system to record suspected Medicare fraud and abuse.
Duties include, but are not limited to:
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
MINIMUM QUALIFICATIONS (MQs):
There are two ways to qualify for this position: 1) Experience OR 2) A Combination of Education and Experience
Option 1: Experience
Option 2: A Combination of Education AND Experience
OR
Document this experience in your application IN DETAIL, as your experience will not be inferred or assumed. Part time experience will be prorated.
SUBSTITUTIONS:
Preferred Qualifications:
Required Competencies: The following knowledge, skills, abilities, and personal characteristics are required competencies and may be considered during the selection process (including examination and/or interview):
Conditions of Employment: Candidates who fail to meet the conditions of employment will be removed from consideration.
The successful passing of a reference check and/or, if required, a background check.
A reference check may include but is not limited to: contacting previous and current supervisors to verify employment and discuss performance, a review of the personnel file, a review of the performance record, a review of job-related public information, etc.
The type of background check depends on the job duties of the position, and can include a review of any criminal record, credit report, and/or driving record.
Ability to travel independently, including work in-office, as required by business need and scheduled by the supervisor.
Must possess and maintain a valid State of Colorado drivers license. This position requires the ability to travel up to 20% of the time, including staying over weekends when required; and the ability to transport equipment, including, but not limited to, laptop computers, manuals, and supplies.
Supplemental Information
PLEASE READ - Required Application Materials
Interested individuals must submit the following online:
A completed State of Colorado Application (log-in to your current NeoGov account or create a NeoGov account to complete the online application). Note: Incomplete applications, including incomplete work history sections or "see résumé," "see attachment," or "see addendum" statements, will not be accepted in lieu of a completed application form.
A current email address on your application, as all communication pertaining to this position will be conducted via email. Please set up your email to accept messages from info@governmentjobs.com and '@state.co.us' addresses, and check your email often. Note: The department cannot guarantee the successful delivery of email, including incorrect filtering into junk mail folders.
A detailed cover letter, explaining how you meet the required competencies and how your accomplishments, qualifications, skills, areas of expertise, personal characteristics, etc. make you a good fit for this position; you may also attach additional documents that demonstrate this.
Comparative Analysis Process: Structured Application Review
Part of, if not the entire, comparative analysis process for this position will involve a review of the information you submit in your application materials; Therefore, it is paramount that in the experience portion of your application and cover letter, you describe the extent to which you possess the education, experience, and competencies outlined in the job announcement as well as the required and/or preferred qualifications/competencies. You are also encouraged to attach additional documents to that effect. Failure to include adequate information or follow instructions may affect your score and prevent you from competing in subsequent measures used to arrive at a top group of applicants.
Part of the comparative analysis process and/or the interview process may be conducted through remote video conferencing (i.e. Google Meet, Zoom, etc.)
Veterans' Preference: Candidates who wish to assert Veterans' Preference should attach a copy of their DD214 to their application. Failure to do so will result in being denied Veterans Preference.
PLEASE NOTE: Former State Personnel System employees who were disciplinarily terminated or resigned in lieu of termination must disclose this information on the application. Colorado Revised Statutes require that all state employees be hired and promoted through competitive examination of merit and fitness. Failure to include the required information, failure to follow instructions, and/or failure to submit materials by the application deadline may result in your application not being considered for the position and may affect your score or inclusion in the final pool of qualified candidates.
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.
ADAAA Accommodations: DORA 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, at dora_adacoordinator@state.co.us.
Check out our excellent benefits package!
THIS ANNOUNCEMENT MAY BE USED TO FILL MULTIPLE VACANCIES
While a salary range is posted for this position, an eventual salary offer is determined by a comprehensive salary analysis, which considers multiple factors including but not limited to education and experience compared to others in the organization doing substantially similar work.
Appeal Rights:
If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.
An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email, US Mail, faxed or hand-delivered within ten (10) calendar days from your receipt of notice or acknowledgment of the department's action.
For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board go to spb.colorado.gov or refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Directors Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules.
HOW TO APPLY: Thank you for your interest. Submit an on-line application by clicking the link below or submit a State of Colorado Application for Announced Vacancy and all supplemental questions according to the instructions provided below. 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 above.
IF NOT APPLYING ON-LINE, SUBMIT APPLICATION TO:
Only online applications will be accepted for this position.
DEPARTMENT CONTACT INFORMATION:
Thanh Pham: thanh.pham@state.co.us
METHODS OF APPOINTMENT: Appointment to the vacancy or vacancies represented by this announcement is expected to be from the eligible list created. However, at the discretion of the appointing authority, the position(s) may be filled by another method of appointment for a valid articulated business reason.
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 agencys 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
DORA Q1: Please provide your Social Security Number. NOTE: This information will be kept strictly confidential and is only accessible to Human Resources Personnel.
02
DORA Q2: Are you a current or previous State of Colorado employee? Enter "yes" or "no" in the space provided. If "yes", enter 1) the State agency name, 2) dates of employment, and 3) your official classification title.
03
DORA Q3: If you are a current or former State of Colorado classified employee, have you ever been disciplinary terminated, resigned in lieu of termination, or deemed to have resigned without notice (Board Rule 7-6, Automatic Resignation)? NOTE: Current and former State Personnel System employees who were disciplinary terminated, resigned in lieu of termination, or who were deemed to have resigned without notice (Board Rule 7-6, Automatic Resignation) must disclose this information on the application. Failure to disclose this information and/or falsification of application materials may result in being removed from consideration for this position.
04
DORA Q4: Current or Former Classified Employees: Are you a transfer, non-disciplinary (voluntary) demotion, or reinstatement applicant?
05
DORA Q5: VETERANS PREFERENCE NOTE: If you are not eligible for/seeking Veterans Preference, please skip down to the bottom and select option "N/A". REQUIRED DOCUMENTATION: Candidates who wish to assert Veterans Preference should attach a copy of their DD214 reflecting dates of service, type of discharge, and, if appropriate, a campaign badge or service medal. If information regarding a campaign badge or service medal is necessary to award preference points and is not reflected on the DD214, other documents reflecting the grade or medal must be provided. Other types of documentation may be required for ten point preference. Note 1: For a complete list of service dates and campaigns used in awarding preference points visit: http://www.opm.gov/veterans/html/vgmedal2.htm Note 2: Medal holders and Gulf War veterans who originally enlisted after September 7, 1980, or entered active duty on or after October 14, 1982, without having previously completed 24 months of continuous active duty; must have served continuously for 24 months or the full period called or ordered to active duty. Note 3: Effective October 1, 1980, military retirees at or above the rank of major or equivalent, are not entitled to preference unless they qualify as disabled veterans. Reservists who are retired from the Reserves but are not receiving retirement pay are not considered "retired military" for purposes of veterans preference. REMINDER: Proof of eligibility must be provided before points are allowed. Please attach documentation to your application. If you have not done so, please go back and do so now. Veterans Preference points WILL NOT be applied without the appropriate documentation. PLEASE CHECK ALL THAT APPLY:
06
DORA Q6: Part of the required application materials includes a detailed cover letter, explaining how you meet the required competencies and how your accomplishments, qualifications, skills, areas of expertise, personal characteristics, etc. make you a good fit for this position; you may also attach additional documents that demonstrate this. Q: Have you included this cover letter as an attachment to your application? (If not, you may go back and do so now). Yes, I have attached the required cover letter explaining how I meet the required competencies and how my accomplishments, qualifications, skills, areas of expertise, personal characteristics, etc. make me a good fit for this position; I may also attach additional documents that demonstrate this. No, I have not attached the required cover letter to my application. Note: I understand that failure to include this information and follow instructions may prevent me from competing in subsequent measures used to arrive at a top group of applicants.
07
DORA Q7: This position requires the ability to travel up to 20% of the time, including staying over weekends when required, and the ability to transport equipment, including, but not limited to, laptop computers, manuals, and supplies.
08
DORA Q8: This position requires the ability to travel up to 20% of the time, including staying over weekends when required. In order to be considered for this position, you must possess and maintain a valid State of Colorado drivers license. Please provide your Colorado drivers license number in the space provided.
09
DORA Q9: Do you currently possess an associates/bachelors degree in business, communications, healthcare administration, healthcare management, public health, health economics, public administration, public policy, project management, criminal justice, or a field of study directly related to the work assignment? If so, please list the type of degree below.
10
DORA Q10: Please explain IN DETAIL how you meet the following minimum qualifications: Six (6) years of professional* experience working for a healthcare provider, a non-profit health advocacy organization, in the health insurance industry, in a health policy consulting environment, or for a governmental regulatory entity, which must include three (3) out of the four (4) of the following: I. Handling health insurance, Medicaid, and/or Medicare-related inquiries; II. Experience with fraud prevention and anti-fraud awareness; III. Coordinating and engaging in educational training about healthcare and/or healthcare fraud prevention; and/or IV. Recordkeeping, information gathering, and/or document organization. NOTE: If you answered yes to DORA Q9 with an associates degree, the experience requirement is four (4) years. If you answered yes to DORA Q9 with a bachelors degree, the experience requirement is two (2) years.
11
DORA Q11: Please explain IN DETAIL how you meet the following preferred qualifications: Demonstrated professional* experience working in a state government body reviewing public health and/or insurance complaints.
12
DORA Q12: Please explain IN DETAIL how you meet the following preferred qualifications: Demonstrated professional* experience working in a fast-paced, high-volume environment, and adapting to shifting priorities, as needed.
13
DORA Q13: Please explain IN DETAIL how you meet the following preferred qualifications: Demonstrated professional* experience working with various, vulnerable communities/populations.
14
DORA Q14: Please explain IN DETAIL how you meet the following preferred qualifications: Demonstrated professional* experience investigating insurance fraud and/or conducting training about health care or health fraud prevention to consumers.
15
DORA Q15: Please explain IN DETAIL how you meet the following preferred qualifications: Demonstrated professional* experience with healthcare fraud prevention and/or reporting suspected fraud.
16
DORA Q16: Please explain IN DETAIL how you meet the following preferred qualifications: Demonstrated professional* experience with managing case-work, collaborating with others to analyze a case, and/or facilitating case resolution.
17
DORA Q17: Although this position will be designated under the departments hybrid workplace program, it will still be required to report to the department office on a scheduled basis and at the discretion of the supervisor, based on business needs. Would you be able to do this?
18
DORA Q18: The salary range posted for this position is $59,460 - $77,268 annually ($4,955 - $6,439/monthly); while appointments are typically made at or near the range minimum, the salary will be set based on the qualifications of the candidate appointed and relevant factors. Please share your salary expectations below.
19
DORA Q19: If you move forward in this process and are selected for this position, what is the earliest date that you would be able to start?
Required Question
Employer State of Colorado
Address See the full announcement by clicking
the "Printer" icon located above the job title
Location varies by announcement, Colorado, --
Website https://careers.colorado.gov/