Eligibility Specialist

Eligibility Specialist I

Department of Health and Human Services (DHHS)

Location: Houlton

This opening is a hybrid position with a partial in office requirement.

Core Responsibilities:

As an Eligibility Specialist I, you'll play a vital role in connecting Maine residents to the health coverage they need through MaineCarethe state's largest health insurance program serving lower-income adults, children, older adults, and people with disabilities. In this position, you'll help people navigate important life situations while ensuring accuracy in determining eligibility. The work is fast-paced, collaborative, and mission-driven with a strong focus on customer service, problem solving, and teamwork.

What you'll do:

Evaluate information and apply program standards to accurately determine MaineCare eligibility and benefits.

Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.

Clearly explain MaineCare rules, requirements, and decisions to applicants and membersboth in writing and over the phone.

Review and process information received electronically or by mail to ensure completeness and compliance.

Connect individuals with additional programs and services that may support their health and well-being.

Strong communication and interpersonal skills are essential as you'll work with people from diverse backgrounds, with varying needs, and help them navigate complex systems during moments that matter.

Minimum Qualifications:

To qualify for this position, you must have a two (2) year combination of training, education, and/or experience in a health or human services setting which demonstrates competency in applying policies and rules to make decisions, maintaining and verifying digital records, and/or responding to client requests.

Thinking about applying?

Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you're currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your lived experience and passion set you apart.

Benefits of working for the State of Maine:

• Work-Life Fit Rest is essential. Take time for yourself using 13 paid holidays and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave. When you or immediate members of your family are ill, utilize 12 days of sick leave per year.
• Health Insurance Coverage The State of Maine pays 85%-95% of employee-only premiums ($12,213.60 - $13,650.48 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.
• Health Insurance Premium Credit Participation decreases employee-only premiums by 5%. Visit the Office of Employee Health and Wellness for more information about program requirements.
• Dental Insurance The State of Maine pays 100% of employee-only dental premiums ($365.28 annual value).
• Retirement Plan The State contributes the equivalent of 14.06% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS), on behalf of the employee.
• Gym Membership Reimbursement Improve overall health with regular exercise and receive up to $40 per month to offset this expense.
• Health and Dependent Care Flexible Spending Accounts Set aside money pre-tax to help pay for out-of-pocket health care expenses and/or daycare expenses.
• Public Service Student Loan Forgiveness The State of Maine is a qualified employer for this federal program. For more information, visit the Federal Student Aid office.
• Living Resources Program Navigate challenging work and life situations with our employee assistance program.
• Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a childincluding non-birthing and adoptive parentsreceive six weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act.
• Voluntary Deferred Compensation Save additional pre-tax funds for retirement in a MaineSaves 457(b) account through payroll deductions.

State employees are eligible for an extensive and highly competitive benefits package, covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.

Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for anything less than full-time.