Eligibility Specialist I

maine; Calais (ME); Hybrid; USD 26,000 - 36,000; Full time

Benefits offered by this job

13 paid holidays

3+ weeks of vacation leave

Health insurance coverage

Job summary

Department of Health and Human Services (DHHS) in Maine seeks an Eligibility Specialist I to connect residents with MaineCare benefits and help navigate health coverage needs.

The role requires applying program standards accurately, using multiple systems to manage data, and communicating rules clearly by phone and in writing. The position emphasizes teamwork, problem solving, and customer service in a fast-paced environment.

Qualifications

• Two-year combination of training, education, and/or experience in a health or human services setting.
• Ability to apply policies and rules to make decisions and verify digital records.
• Experience using multiple technology systems to enter, review, and verify eligibility information.

Responsibilities

• Evaluate information and apply program standards to determine MaineCare eligibility and benefits.
• Use multiple technology systems to enter, review, and verify eligibility data.
• Explain MaineCare rules, requirements, and decisions to applicants and members 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 health and well-being.

Skills

Communication skills

Customer service

Problem solving

Teamwork

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 of Health and Human Services (DHHS)

Opening Date: August 7, 2026Closing Date: August 20, 2026Job Class Code: 5075Grade: 18 (Professional & Technical Services)Salary: $19.02 - $26.48 per hour**New State employees begin at Step 1, $19.02 per hourLocation: Calais, Ellsworth, Machias, or BangorThis 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.

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 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 depende