Eligibility Specialist I

MaineGuide; Augusta (ME); Hybrid; USD 26,000 - 36,000; Full time

Benefits offered by this job

13 paid holidays

Vacation leave

Health insurance coverage

Retirement plan

Job summary

Department of Health and Human Services (DHHS) in Augusta is seeking an Eligibility Specialist I to determine MaineCare eligibility and benefits. You will assist residents in navigating health coverage, ensuring accuracy and timeliness in processing information in a fast-paced, service-oriented environment.

The role emphasizes clear explanations of MaineCare rules, customer service, and collaboration with diverse communities, with a hybrid in-office requirement.

Qualifications

• Two-year combination of training, education, and/or experience in a health or human services setting.

Responsibilities

• Evaluate information and apply program standards to accurately determine MaineCare eligibility and benefits.
• Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.
• Clearly explain MaineCare rules, requirements, and decisions to applicants and members—both in writing and over the phone.
• Review and process information received electronically or by mail to ensure completeness and compliance.
• Connect individuals with additional programs and services that may support their health and well-being.

Skills

Eligibility determination

Customer service

Data entry

Communication

Tools

MaineCare systems

Job description

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.

Department ofHealth and Human Services (DHHS)

Opening Date:August 7, 2026

Closing Date: August 20, 2026

Job Class Code: 5075

Grade: 18 (Professional & Technical Services)

Salary:$19.02 - $26.48 per hour*

*New State employees begin at Step 1, $19.02 per hour

Location: Augusta

This opening is a hybrid position with a partial in office requirement.

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

Core Responsibilities:

As an Eligibility Specialist I, you’ll play a vital role in connecting Maine residents to the health coverage they need through MaineCare—the state’s largest health insurance program serving lower-income adults, children, older adults, and people with disabilities. In this position, you’ll help people navigate important life situations while ensuring accuracy in determining eligibility. The work is fast-paced, collaborative, and mission-driven with a strong focus on customer service, problem solving, and teamwork.

What you’ll do:

• Evaluate information and apply program standards to accurately determine MaineCare eligibility and benefits.


• Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.


• Clearly explain MaineCare rules, requirements, and decisions to applicants and members—both in writing and over the phone.


• Review and process information received electronically or by mail to ensure completeness and compliance.


• Connect individuals with additional programs and services that may support their health and well-being.

Strong communication and interpersonal skills are essential as you’ll work with people from diverse backgrounds, with varying needs, and help them navigate complex systems during moments that matter.

Minimum Qualifications:

To qualify for this position, you must have a two (2) year combination of training, education, and/or experience in a health or human services setting which demonstrates competency in applying policies and rules to make decisions, maintaining and verifying digital records, and/or responding to client requests.

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 for Family Independence (OFI) connects Maine people and families to services and programs that foster health, safety, resilience, and opportunity including MaineCare (Medicaid), the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and other education and career programs.

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 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 pays85%-95% of employee-only premiums ($12,213.60 - $13,650.48 annual value), depending on salary. Use this chart to find thepremium 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 aboutprogram 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 14.06% 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 leaveis one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing and adoptive parents—receivesix weeks of fully paid parental leave. Additional, unpaid leave may also be available, under theFamily 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.

Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.