Hearings Representative

Department of Health and Human Services (DHHS)

Comprehensive Health Planner II

Opening Date: September 18, 2024

Closing Date: October 1, 2024

Job Class Code: 5050
Grade:  26 (Pro. & Tech)
Salary: $56,264.00 - $78,998.40 per year

Position Number: 02000-2524

Location: The position is located in Augusta, Maine and is eligible to have a hybrid remote work schedule with management approval. 

Core Responsibilities:

This position is primarily responsible for representing the Office of MaineCare Services (OMS) in administrative appeal hearings regarding actions taken by OMS as part of the administration of the MaineCare program. The position sits within the OMS Compliance Division and reports to the Associate Director of Compliance.

As the Hearings Representative for OMS, you will:
•    Represent OMS in administrative appeal hearings to make the best possible case that the Department was correct in taking certain program actions.
•    Participate in pre-hearing conferences.
•    Prepare and submit exhibits to be used during hearings.
•    Prepare witnesses for testifying at hearings.
•    Interpret MaineCare rules and may perform limited legal research.

Hearings are conducted in accordance with the Maine Administrative Procedures Act and the Department of Health and Human Services’ Division of Administrative Hearings regulations.

In addition to the duties related to administrative appeal hearings, this position will assist with other Compliance-related duties, including, but not limited to:

•    Assisting with the processing of Freedom of Access Act requests; 
•    Serving as the Privacy and Security liaison for OMS;
•    Assisting in monitoring and keeping abreast of current and proposed federal and state laws, regulations, policies, and rules that impact or potentially impact OMS programs and operations; and
•    Tracking, monitoring, and leading special projects, as assigned. 

We are seeking an individual who can:
•    Communicate effectively and persuasively verbally and in writing. 
•    Analyze facts and testimony.
•    Reach and present logical conclusions.

Minimum Qualifications:

A Bachelor’s Degree in Public/Community Health, Health Administration, Health Sciences or Health Education; Public Administration, 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:
•    An advanced degree in a related field, such as a law degree (or actively in the process of obtaining a law degree)
•    Experience with administrative hearings and/or litigation
•    Experience in regulatory compliance work
•    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.

Thinking about applying?

Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you’re currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your lived experience and passion set you apart.

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 State's 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 is the office in DHHS that administers the state’s 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 state’s Medicaid program.

Application Information:

 Please submit all documents or files in  PDF format.

For questions, please contact William.logan@maine.gov

To request a paper application, please contact Ashley.Smith@Maine.gov .

Benefits of working for the State of Maine:

No matter where you work across Maine state government, you find employees who embody our state motto—"Dirigo" or "I lead"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total compensation package, including:

• 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%-95% of employee-only premiums ($11,196.96 - $12,514.32 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State. 
• Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($387.92 annual value).
• Retirement Plan – The State contributes the equivalent of 13.29% 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 fathers 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. 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 for anything less than full-time.

There's a job and then there's 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 you’re looking for a great next step, and want to feel good about what you do, we’d love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.