MaineCare Policy Planner
MaineCare Policy Planner
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$ 11196 - 12514
1 Vacancy
Job Description
Department ofHealth and Human Services (DHHS)
Comprehensive Health Planner II
Opening Date: May 16 2025
Closing Date: May 30 2025
Job Class Code: 5050
Grade: 26 (Pro. & Tech. Svcs.)
Salary:$56264.00 $78998.40 per year
Position Number:0
Location: Augusta
Core Responsibilities:
The Policy Planner will develop policy in accordance with federal and state requirements and help ensure that the policy is responsive to the needs of MaineCare members and providers guided by best practice data analysis and interested party feedback. The position requires effective communication including strong analytical writing and presentation skills. This role also involves public hearing facilitation and requires the ability to work collaboratively with diverse groups and agencies.
The position will help OMS adopt policies needed for comprehensive rate system reform which aims to improve MaineCares reimbursement system to ensure rates are equitable and sufficient to provide all MaineCare members with access to needed high value healthcare services. The MaineCare Policy Planner will work collaboratively with other agencies members and providers to understand how these policies best work in practice. They will also recommend changes and updates as needed while conducting rulemaking. This position may work with and actively collaborate on all sections of the MaineCare Benefits Manual (MBM).
The Policy Planner will:
Develop expertise in covered services outlined in the MBM. Evaluate and interpret assigned sections of the MBM analyze standard and best practices nationally and assess compliance with applicable state and federal laws.
Initiate formal MaineCare policy rulemaking through the MAPA process including but not limited to:
o Draft and propose new and existing rules working with various internal and external partners
o Facilitate public hearings and respond to public comments on proposed rules.
o Adopt MaineCare rules
o Evaluate ways to further OMS rate system reform goals with a focus on evidencebased practices.
Work collaboratively with other state offices and with a wide variety of third parties including members providers and advocates
Think critically and strategically to address complex health policy issues and manage multiple priorities at once.
Minimum Qualifications:
A Bachelors Degree in Public/Community Health Health Administration Health Sciences or Health Education; Public Administration Government Social Work or a closely related field and three (3) years professional experience in the planning development coordination and/or evaluation of health programs or services OR an equivalent seven (7) year combination of education training and experience. Preference will be given to candidates with professional experience researching interpreting and writing policy at the program local state or federal level.
Applicants must include a resume cover letter and writing sample with their application.
Preferred experience includes:
Experience with and knowledge of the Medicaid program and/or other health and human services programs serving lowincome populations.
Lived experience with Medicaid and/or other healthrelated social needs common to individuals and families receiving Medicaid coverage.
Knowledge of Alternative Payment Models and valuebased purchasing.
The background of wellqualified candidates must demonstrate the following competencies:
1. Experience with the analysis development interpretation and/or implementation of policy and programs.
2. Knowledge of health care benefit programs (e.g. MaineCare other state Medicaid or private insurance coverage) and relevant issues facing the health care field and health care consumers.
3. Strong analytic and problemsolving skills.
4. Knowledge of Medicaid policy including but not limited to coverage reimbursement eligibility and/or systems.
5. Demonstrated writing editing and proofreading skills including the ability to simplify and summarize technical language and complex subject matter in a concise manner and in alignment with plain language principles. (please provide a writing sample)
6. The ability and motivation to effectively manage multiple long and shortterm projects with diverse contributors.
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Agency information:
The Department of Health and Human Services (DHHS) is dedicated to promoting health safety resilience and opportunity for Maine people. The Department provides health and social services to approximately a third of the States population including children families older Mainers and individuals with disabilities mental illness and substance use disorders. The Department also promotes public health operates two state psychiatric hospitals and provides oversight to health care providers.
The Office of MaineCare Services (OMS) within DHHS administers the states Medicaid program which provides free or lowcost health insurance coverage for lowincome Mainers so they can access the health care services they need to work care for family go to school and participate in the community. OMS works collaboratively with other State agencies the Legislature the Office of the Governor MaineCare members health care providers and other health care purchasers on statewide healthcare improvement initiatives. OMS is committed to advancing health equity efforts to improve access to care and positive health outcomes for all lowincome Mainers. OMS provides benefit coverage and support services in alignment with Department goals federal requirements and State statutes. OMS also provides oversight necessary to ensure accountability and efficient and effective administration of the states Medicaid program.
The OMS Policy Division develops policies and programs that provide eligible Maine residents with access to comprehensive affordable evidencebased health care services. The Division has primary responsibility for planning writing and promulgating administrative rules related to MaineCare covered services through formal rulemaking in accordance with the Maine Administrative Procedure Act (MAPA).
Application Information:
For additional information about this position please contact Heather Pelletier ator Kristin Merrill at
Please submit all documents or files in PDF format.
To request a paper application please contact
Benefits of working for the State of Maine:
No matter where you work across Maine state government you find employees who embody our state mottoDirigo or I leadas they provide essential services to Mainers every day. We believe in supporting our workforces health and wellbeing with a valuable total compensation package including:
- WorkLife Fit Rest is essential. Take time for yourself using 13 paid holidays 12 days of sick leave and 3 weeks of vacation leave annually. Vacation leave accrual increases with years of service and overtimeexempt employees receive personal leave.
- Health Insurance Coverage The State of Maine pays 85%95% of employeeonly premiums ($11196.96 $12514.32 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.
- Dental Insurance The State of Maine pays 100% of employeeonly dental premiums ($387.92 annual value).
- Retirement Plan The State contributes the equivalent of 13.29% of the employees pay towards the Maine Public Employees Retirement System (MainePERS).
Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a childincluding fathers and adoptive parentsreceive six weeks of fully paid parental leave. Additional unpaid leave may also be available under the Family and Medical Leave Act.
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 foranything less than fulltime.
Theres a job and then theres purposeful transformative work. Our aim is to create a workplace where you can learn grow and continuously refine your skills. Applicants demonstrate job requirements in differing ways and we appreciate that many skills and backgrounds can make people successful in this role.
As an Equal Opportunity employer Maine State Government embraces a culture of respect and awareness. We are committed to creating a strong sense of belonging for all team members and our process ensures an inclusive environment to applicants of all backgrounds including diverse race color sex sexual orientation or gender identity physical or mental disability religion age ancestry national origin familial status or genetics.
If youre looking for a great next step and want to feel good about what you do wed love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.
Employment Type
Full-Time
