Eligibility Specialist I

Department of Health and Human Services • Wilton, CT

1d • $19 - $26 • Hybrid

About The Position

As an Eligibility Specialist I, you’ll play a vital role in connecting Maine residents to the health coverage they need through MaineCare—the 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.

Requirements

• 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.

Responsibilities

• 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 members—both 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.

Benefits

• Work-Life 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 overtime-exempt employees receive personal leave.
• Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($12,845.82 - $15,112.76 annual value), depending on salary.
• Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%.
• 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 employee's 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 child—including non-birthing and adoptive parents—receive 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed