Eligibility and Enrollment Analyst

MaineGuide; Augusta (ME); Hybrid; USD 65,000 - 92,000; Full time

Benefits offered by this job

Health Insurance

Retirement Plan

Parental leave

Wellness programs

Job summary

The Eligibility and Enrollment Analyst role at the Department of Health and Human Services in Augusta, ME focuses on data analysis for MaineCare eligibility and enrollment trends. The position develops cost analyses and forecasts related to future legislation and PMPM costs.

You will partner with OMS and OFI, build analytical datasets, and deliver reports to support budget and program decisions. Strong SQL and Excel skills are required. Salary reflects Maine state pay scales.

Qualifications

• Bachelor’s degree plus 2 years of data analysis or financial analysis experience.
• Experience analyzing Medicaid or health program data preferred.
• Strong SQL and spreadsheet skills with data visualization ability.

Responsibilities

• Create MaineCare member enrollment reports.
• Coordinate with OFI to analyze eligibility and enrollment data.
• Create analytical datasets from OMS and OFI data sources.
• Validate data integrity in MaineCare data warehouses.
• Prepare reports, visualizations, analyses and forecasts.
• Present analyses to MaineCare senior management and other units.
• Collaborate on projects from ad-hoc to long-term initiatives.
• Develop fiscal impact analyses for legislative bills and budgets.

Skills

SQL

Data analysis

Pivot tables

Communication

Education

Bachelor's degree in Data Analytics, Statistics, Economics, Business Administration, or related field

Tools

Excel

Job description

DepartmentofHealth and Human Services (DHHS)

Public Service Coordinator I

Opening Date:September 3, 2026

Closing Date:September 17, 2026

Job Class Code:CA26

Grade:26 (Confidential)

Salary:$64,916.80 - $91,769.60 per year

Position Number:20002-5211

Location:Augusta

Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

Job Description:

The Eligibility and Enrollment Analyst provides key information obtained through data analysis related to eligibility and enrollment trends and associated programmatic impacts. This position will create fiscal impact analyses related to future state and federal legislation impacting MaineCare member enrollment and will assist in creating and applying per member per month (PMPM) cost analysis. This position will research and incorporate the impact of broader economic trends into enrollment forecasting.

As an Eligibility and Enrollment Analyst, you will:

• Create MaineCare member enrollment reports.
• Coordinate with the Office for Family Independence (OFI) to gather and analyze eligibility and enrollment data and share relevant Office of MaineCare Services (OMS) data back to OFI.
• Create analytical datasets by integrating multiple raw data sources from both OMS and OFI using a variety of programming languages and data management tools.
• Validate and maintain data integrity within MaineCare’s data warehouses, decision support and claims processing systems.
• Prepare reports, data visualizations, analyses, and forecasts to support clinical, operational, and budgetary initiatives.
• Present analyses and recommendations to the MaineCare senior management team, OFI, or other units within the Department.
• Work individually and as part of multi-disciplinary teams on projects varying in size and scope from short-term ad-hoc requests to long-term strategic initiatives while collaborating with other OMS units and DHHS offices.
• Develop fiscal impact analyses for Legislative bills and for Department budget initiatives.

Minimum Qualifications:

In order to qualify for this position, you must have a six (6) year combination of education and/or experience that includes a bachelor’s Degree in Data Analytics, Statistics, Economics, Business Administration, or a closely related field -AND- two (2) years of responsible experience in data analysis, accounting, and/or financial analysis. Directly related professional experience may be substituted for education on a year-for-year basis. Prior experience in analyzing Medicaid program or financial data is preferred.

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

The background of well-qualified candidates will demonstrate the following competencies:

• Prior experience in analyzing program details and eligibility/enrollment for Medicaid or other social service programs.
• The ability to accurately interpret, apply, and communicate the impact of changes to both state and federal regulations.
• Advanced technical skills in the use of programming tools such as SQL and spreadsheets (e.g., pivot tables, functions, macros/Visual Basic script, etc.), along with database query/reporting methodologies and statistical analysis skill sets.
• Familiarity with public administration and financial management processes, practices, and techniques.
• The ability to communicate effectively, whether orally, in writing, or through the use of data visualizations.

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 Analytics team is located within a broader OMS Data Analytics unit. The Analytics team supports OMS and broader DHHS operations, initiatives, and decision-making through the analysis of financial and healthcare data. As a member of the Analytics team, the Eligibility and Enrollment Analyst works to maximize the health and wellness of the MaineCare population by coordinating data collection between OMS and the Office for Family Independence (OFI) and performing data analysis related to MaineCare member eligibility.

Benefits of working for the State of Maine:

• Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave. When you or immediate members of your family are ill, utilize 12 days of sick leave per year.
• Health Insurance Coverage – The State of Maine pays 85%-95% of employee-only premiums ($12,213.60 - $13,650.48 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.
• Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%. Visit the Office of Employee Health and Wellness for more information about program requirements.
• Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($365.28 annual value).
• Retirement Plan – The State contributes the equivalent of 18.86% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS), on behalf of the employee.
• Gym Membership Reimbursement – Improve overall health with regular exercise and receive up to $40 per month to offset this expense.
• Health and Dependent Care Flexible Spending Accounts – Set aside money pre-tax to help pay for out-of-pocket health care expenses and/or daycare expenses.
• Public Service Student Loan Forgiveness – The State of Maine is a qualified employer for this federal program. For more information, visit the Federal Student Aid office.
• Living Resources Program – Navigate challenging work and life situations with our employee assistance program.
• 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.
• Voluntary Deferred Compensation – Save additional pre-tax funds for retirement in a MaineSaves 457(b) account through payroll deductions.

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 foranything 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.

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