Eligibility Specialist I

State of Maine•Farmington, NM

6d•Hybrid

About The Position

The Eligibility Specialist I helps Maine residents access health coverage through MaineCare, the state’s health insurance program serving lower-income adults, children, older adults, and people with disabilities. The position evaluates information and applies program standards to determine eligibility and benefits accurately, while helping applicants and members navigate complex rules and systems. The work is described as fast-paced, collaborative, and mission-driven, with a focus on customer service, problem solving, teamwork, and accuracy. The position is based in Farmington and is hybrid, with a partial in-office requirement. It is not eligible for visa sponsorship or STEM OPT extensions. The Department of Health and Human Services’ Office for Family Independence connects Maine people and families with programs including MaineCare, SNAP, TANF, and other education and career programs.

Requirements

Two years of combined training, education, and/or experience in a health or human services setting demonstrating competency in applying policies and rules to make decisions, maintaining and verifying digital records, and/or responding to client requests.
Strong communication and interpersonal skills.

Responsibilities

Evaluate information and apply program standards to determine MaineCare eligibility and benefits accurately.
Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.
Explain MaineCare rules, requirements, and decisions to applicants and members 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.
Work with people from diverse backgrounds and varying needs, helping them navigate complex systems.

Benefits

13 paid holidays and at least three weeks of annual vacation leave; vacation accrual increases with service, and overtime-exempt employees receive personal leave.
12 days of sick leave per year.
State-paid contribution of 85%–95% of employee-only health insurance premiums, depending on salary; dependent coverage is also available.
A 5% employee-only health insurance premium credit for participation in the program.
State-paid employee-only dental insurance premiums.
State contribution equivalent to 14.06% of employee pay toward MainePERS retirement.
Gym membership reimbursement of up to $40 per month.
Health and dependent care flexible spending accounts.
Eligibility for Public Service Student Loan Forgiveness.
Employee assistance program through the Living Resources Program.
Six weeks of fully paid parental leave for employees welcoming a child, including non-birthing and adoptive parents; additional unpaid leave may be available under the Family and Medical Leave Act.
Voluntary MaineSaves 457(b) deferred compensation plan.
Additional wellness benefits for State employees.