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MaineCare Policy Planner

State of Maine

Augusta, Maine

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JOB DETAILS
SALARY
$56,264–$78,998.40
SKILLS
Analysis Skills, Behavioral Health, Best Practices, Case Management, Child and Youth Services, Communication Skills, Community Health, Data Analysis, Data Collection, Department of Health and Human Services, Federal Laws and Regulations, Government, Health Education, Health Plan, Health Science, Healthcare, Healthcare Administration, Healthcare Reimbursement, Hospital, Legal, Medicaid, Multitasking, Outpatient Care, Patient Care, Policy Development, Presentation/Verbal Skills, Problem Solving Skills, Program Evaluation, Public Administration, Public Health, Public Policy, Regulations, Reimbursement, Social Work, State Laws and Regulations, Team Player, Writing Skills
LOCATION
Augusta, Maine
POSTED
16 days ago
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 State's career page and indicate on the application that they have previously worked for the State.
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Department of Health and Human Services (DHHS)

Comprehensive Health Planner II

Opening Date: April 17, 2026

Closing Date: May 13, 2026

Job Class Code: 5050

Grade: 26 (Professional & Technical Services)

Salary: $56,264.00 - $78,998.40 per year

Position Number: 02000-3232, 02031-2283

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 writer's 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 MaineCare's 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 Benets 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
  • children's 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 Bachelor's Degree in Public/Community Health, Health Administration, Health Sciences or Health Education; Public Administration, Public Policy, Law/Legal Studies, 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 low-income populations.
  • Lived experience with Medicaid and/or other health-related social needs common to individuals and families receiving Medicaid co

About the Company

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State of Maine

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