Pueblo CMA Coordinator, Prior Authorization Request

THE RESOURCE EXCHANGE•Pueblo, CO

1d•Onsite

About The Position

The Resource Exchange (TRE) is a mission-driven organization dedicated to transforming lives by supporting individuals with intellectual and developmental disabilities (IDD), behavioral health needs, and long-term service and support needs across Southern Colorado. Recognized as one of Colorado’s Best Workplaces for five consecutive years, TRE's team of over 400 passionate members is committed to purpose, compassion, and improving systems for individuals and families. This administrative role is crucial for ensuring individuals with disabilities receive timely access to essential services. The Pueblo CMA Coordinator will support individuals with IDD and long-term care needs, help families navigate complex Medicaid waiver systems, and work in an environment focused on inclusion, dignity, and person-centered care. TRE supports over 12,000 individuals across Colorado through various disability services, behavioral health supports, early intervention, and long-term care programs, with a team dedicated to independence, strong communities, and advocacy. The Pueblo CMA Coordinator – Prior Authorization Requests specifically plays a key role in ensuring individuals receiving Medicaid waiver services have timely, accurate, and compliant access to care. This position focuses on preparing, reviewing, and submitting Prior Authorization Requests (PARs) for Long-Term Services and Supports (LTSS), ensuring compliance with Colorado HCPF regulations and Medicaid waiver requirements. The coordinator will collaborate closely with Service Coordinators, providers, families, and state partners to prevent service delays and ensure continuous critical support.

Requirements

Experience working with individuals with intellectual and developmental disabilities (IDD) (strongly preferred)
Knowledge or exposure to Medicaid waiver programs, LTSS, or case management
Strong attention to detail and ability to manage complex documentation requirements
Ability to work in fast-paced, compliance-driven environments
Strong communication and collaboration skills
Comfort working within multiple data systems and regulatory guidelines
A commitment to person-centered service and supporting vulnerable populations

Nice To Haves

Case management, waiver coordination, or prior authorization experience
Work in disability services, behavioral health, or human services
Familiarity with Colorado HCPF systems and Medicaid processes

Responsibilities

Prepare, review, and submit Prior Authorization Requests (PARs) for LTSS services
Ensure compliance with Colorado Medicaid waiver rules and HCPF regulations
Review documentation for accuracy, eligibility, and medical necessity
Collaborate with Service Coordinators, providers, and state partners
Resolve denials, discrepancies, and documentation issues with urgency and professionalism
Maintain accurate records in state systems (MMIS, BUS, CCM, Bridge, etc.)
Track PAR status and ensure timely submission and follow-up
Support continuous improvement in documentation and authorization processes
Advocate for individuals receiving waiver services through accurate and timely processing