Location: Augusta,Maine,United States
Department of Health and Human Services (DHHS)
Comprehensive Health Planner II
Opening Date: October 21, 2024
Closing Date: November 1, 2024
Job Class Code: 5050
Grade: 26 (Pro. & Tech. Svcs.)
Salary: $56,264.00 - $78,998.40 per year
Position Number: 02000-4108
Location: Augusta
(This position is eligible for partial telework with management approval)
Core Responsibilities:
As a Comprehensive Health Planner II in the Policy Division, the Policy Planner will help OMS adopt policies necessary for implementation of its plan for comprehensive rate system reform, which aims to streamline, rationalize and 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 Policy Planner will develop expertise in covered services as outlined in assigned sections of the MaineCare Benefits Manual (MBM) and in MAPA processes. They will work collaboratively with other OMS staff, DHHS Offices, the Office of the Attorney General, and external stakeholders, including members and providers, to understand the way these sections work in practice, research best practices and legal requirements, recommend changes and updates, and enact changes through rulemaking. This position may work with and actively collaborate on all sections of the MBM.
The Policy Planner will:
• Draft and propose new rules, working with various internal and external stakeholders.
• Initiate formal MaineCare policy rulemaking through the MAPA process, including proposal and adoption of MaineCare rules, facilitating public hearings as necessary, and responding to public comment on proposed rules.
• Evaluate and interpret assigned sections of the MBM, including analysis of standard and best practices nationally and compliance with applicable state and federal laws.
• Evaluate ways to further OMS’s rate reform goals, including a focus on supporting evidence-based practices.
• Work collaboratively with a wide variety of stakeholders including internal staff, other state offices, providers, members, and advocates.
• Think critically and strategically to address complex health policy issues and manage multiple priorities simultaneously.
The position works to create policy that is responsive to the needs of MaineCare members and providers as guided by best practice, data analysis, and stakeholder feedback. The position requires effective communication, including strong analytical and writing skills, presentation delivery and public hearing facilitation, and the ability to work collaboratively with diverse groups and agencies.
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 professional experience researching, interpreting, and writing policy at the program, local, state, or federal level.
Applicants must include a resume and cover letter 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 coverage.
• Knowledge of Alternative Payment Models and value-based purchasing.
The background of well-qualified candidates must demonstrate the following competencies:
1. Experience with the analysis, development, interpretation and/or implementation of policy and programs.
2. Knowledge of health care benefit programs (e.g. MaineCare, other state Medicaid, or private insurance coverage) and relevant issues facing the health care field and health care consumers.
3. Strong analytic and problem-solving skills.
4. Knowledge of Medicaid policy, including but not limited to, coverage, reimbursement, eligibility, and/or systems.
5. Demonstrated writing, editing and proofreading skills, including the ability to simplify and summarize technical language and complex subject matter in a concise manner and in alignment with plain language principles. (please provide a writing sample)
6. The ability and motivation to effectively manage multiple long- and short-term projects with diverse stakeholder groups.
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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 (OMS) within DHHS 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.
The Policy Division is responsible for the development of policies and programs that provide eligible Maine residents with access to comprehensive, affordable, evidence-based health care services. The unit has primary responsibility for planning, writing, and promulgating administrative rules related to MaineCare covered services through formal rulemaking consistent with the Maine Administrative Procedure Act (MAPA).
Application Information:
For additional information about this position please contact Kristin Merrill at Kristin.Merrill@Maine.gov
Please submit all documents or files in PDF format.
To request a paper application, please contact Mandy.L.Harman@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 costsfor 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.
