Eligibility Specialist I

State of Maine•Calais, ME

1d•$20 - $28•Hybrid

About The Position

The Eligibility Specialist I works for the Maine Department of Health and Human Services, helping Maine residents access MaineCare, the state’s largest health insurance program. The role evaluates applications and supporting information to determine eligibility and benefits accurately, and explains program requirements and decisions to applicants and members. The work is fast-paced, collaborative, and focused on customer service, problem solving, and teamwork, including assisting people from diverse backgrounds as they navigate complex systems.

Requirements

Two years of combined training, education, and/or experience in a health or human services setting.
Demonstrated 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 clearly to applicants and members in writing and by phone.
Review and process information received electronically or by mail for completeness and compliance.
Connect individuals with additional programs and services that may support their health and well-being.

Benefits

13 paid holidays and at least three weeks of annual vacation leave, with vacation accrual increasing with years of service.
Personal leave for overtime-exempt employees.
12 days of sick leave per year.
Health insurance, with the State paying 85%–95% of employee-only premiums, depending on salary.
A 5% employee-only health insurance premium credit for eligible participants.
Dental insurance, with the State paying 100% of employee-only premiums.
State contribution equivalent to 14.06% of employee pay toward the Maine Public Employees Retirement System.
Gym membership reimbursement of up to $40 per month.
Health and dependent care flexible spending accounts.
Eligibility for Public Service Student Loan Forgiveness through the State’s qualified-employer status.
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.
Potential additional unpaid leave under the Family and Medical Leave Act.
Voluntary deferred compensation through a MaineSaves 457(b) account.