MaineCare Policy Planner

If you are a current State of Maine employee please submit your application through the internal application process using the Find Jobs report in PRISM. Seasonal employees who do not have PRISM access should apply through the States career page and indicate on the application that they have previously worked for the State.

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Department ofHealth and Human Services (DHHS)

Comprehensive Health Planner II

Opening Date: April 17 2026

Closing Date:May 1 2026

Job Class Code:5050

Grade:26 (Professional & Technical Services)

Salary:$56264.00 $78998.40 per year

Position Number:0

Location:Augusta

This position allows for partial telework with management approval.

Currently this position is not eligible for visa sponsorship or STEM OPT extensions.

Core Responsibilities:

The Policy Planner will develop policies that describe the health care services covered by MaineCare and how MaineCare reimburses for those services. The Policy Planner works with internal and external partners to develop these policies in accordance with federal and state requirements and with the goal of meeting the needs of MaineCare members and providers. This includes researching Medicaid policies in other states staying up to date on Medicaid regulations that relate to the policy writers areas of focus and reviewing best practices data analyses and collecting interested party feedback The position requires effective communication including strong analytical writing and presentation skills. This role also involves working collaboratively with diverse groups and agencies including holding public hearings.

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. This position may work with and actively collaborate on all sections of the MaineCare Benefits Manual (MBM) the state rules governing the MaineCare program - but may have a primary focus in either:

• outpatient clinic and hospital services including medical and preventative services and programs; or

• childrens and behavioral health services including home and community-based residential and inpatient behavioral health services case management services and health home services for children and adults with behavioral health conditions.

The Policy Planner will:

• Develop expertise in their assigned MaineCare covered services including qualified providers best practices how payments are made reimbursement methodology and compliance with applicable state and federal laws.
• Initiate formal MaineCare policy rulemaking through the MAPA process including but not limited to:

• Draft new rules and/or changes to existing rules working with various internal and external partners.
• Facilitate public hearings and respond to public comments on proposed rules.

• Work collaboratively with internal teams and 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.
• Effectively research healthcare best practice state statute and federal regulations to inform policy development.

Minimum Qualifications:

A Bachelors Degree in Public/Community Health Health Administration Health Sciences or Health Education; Public Administration Public Policy Law/Legal Studies GovernmentSocial 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 low-income populations.
• Lived experience with Medicaid and/or other health-related social needs common to individuals and families receiving Medicaid coverage.
• Knowledge of Alternative Payment Models and value-based purchasing.

The background of well-qualified candidates must demonstrate the following competencies:

• Experience with the analysis development interpretation and/or implementation of policy and programs.

• 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.

• Strong analytic and problem-solving skills.

• Knowledge of Medicaid policy including but not limited to coverage reimbursement eligibility and/or systems.
• 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.
• The ability and motivation to effectively manage multiple long- and short-term projects with diverse stakeholder groups.

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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 low-cost health insurance coverage for low-income 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 low-income 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 Policy Division is responsible for the development of policies and programs that provide eligible Maine residents with access to comprehensive affordable evidence-based health care services. The unit has primary responsibility for planning writing and promulgating administrative rules related to MaineCare covered services through formal rulemaking consistent with the Maine Administrative Procedure Act (MAPA).

Application Information:

For questions about this position please contact Heather Pelletier at or Henry Eckerson at .

Please submit all documents or files in PDF or Word 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:

• Work-Life Fit Rest is essential. Take time for yourself using13 paid holidays 12 days of sick leave and3 weeks of vacation leaveannually. Vacation leave accrual increases with years of service and overtime-exempt employees receive personal leave.
• Health Insurance Coverage The State of Maine pays85%-100%of employee-only premiums ($12845.82 - $15112.76 annual value) depending on salary. Use this chart to find thepremium costsfor 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 aboutprogram requirements.
• Dental Insurance The State of Maine pays 100% of employee-only dental premiums ($395.72 annual value).
• Retirement Plan The State contributes the equivalent of 14.11% of the employees pay towards the Maine Public Employees Retirement System (MainePERS).
• Parental leaveis one of the most important benefits for any working parent. All employees who are welcoming a childincluding non-birthing and adoptive parentsreceivesix weeks of fully paid parental leave. Additional unpaid leave may also be available under theFamily and Medical Leave Act.

State employees are eligible for anextensive 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 full-time.

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.

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If you are unable to complete the online application please contact the Human Resources representative listed on the job opening you are interested in applying for. They will work with you for an alternative method of submitting.