Eligibility Specialist II – Long Term Care

Department of Health and Human Services; Augusta (ME); Hybrid; USD 31,000 - 43,000; Full time

Benefits offered by this job

Paid holidays

Vacation leave

Health insurance coverage

Retirement plan

Parental leave

Job summary

Department of Health and Human Services in Augusta, Maine is seeking an Eligibility Specialist II to determine initial and continued eligibility for public assistance programs, with a focus on MaineCare policy. The role requires strong customer service and accuracy in a fast-paced environment, handling sensitive information and communicating with clients and agencies.

The position may perform quality control and data entry, and supports confidentiality and ethical standards.

Qualifications

• Four-year combination of education, training, and/or progressively responsible experience in a social services setting.
• Experience in interviewing and data gathering to form judgments in eligibility determinations.
• Bachelor's Degree in Social Services, Business Administration, or related field.

Responsibilities

• Interview clients, collects facts and documentation for eligibility or recertification.
• Evaluate information and apply standards and criteria.
• Explain program eligibility requirements and rights to clients and representatives.
• Review information for accuracy, identify inconsistencies, request documentation, verify data.
• Communicate with clients, co-workers and other agencies in writing and verbally.
• Enter data into an automated system and ensure accurate eligibility results.
• Maintain confidentiality of applicant and recipient information.

Skills

Interviewing

Data gathering

Customer service

Interpersonal skills

Conflict resolution

Education

Bachelor's degree in Social Services

Tools

Automated data system

Job description

Department of Health and Human Services (DHHS) Eligibility Specialist II Opening Date: October 29, 2026 Closing Date: November 12, 2026 Job Class Code: 5073 Grade: 21 (Professional & Technical Services) Salary: $22.51 - $31.50 per hour* *New State employees begin at Step 1, $22.51 per hour Position Number: 02022-7475 Location: Augusta This position allows for partial telework with management approval. Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

Core Responsibilities

Position of Eligibility Specialist II determines initial and continued eligibility for public assistance programs. This vacancy is within the Long-Term Care Eligibility Unit and has a strong focus on MaineCare policy. The position may also perform quality control work by reviewing eligibility decisions made by others. Work is done in a fast-paced environment that has high standards for customer service and program accuracy. The position gathers sensitive and personal information to make timely and accurate eligibility determinations. Strong interpersonal and conflict resolution skills are necessary as the Eligibility Specialist interacts with people from different walks of life and/or in various emotional states.

Typical Duties

• Interview clients, obtains and assesses all necessary facts, data, supporting information, and documentation pertaining to the application or recertification for public assistance.
• Evaluate information and applies allowable standards and criteria.
• Explain program eligibility requirements, rules, regulations and individual rights and responsibilities to clients and their representatives.
• Reviews and analyzes information for accuracy; identifies inconsistencies; requests necessary documentation; verifies and validates data.
• Answers inquiries and refers clients to various programs.
• Accurately enters data into an automated system and ensures accurate eligibility results.
• Communicate verbally and in writing with clients, co-workers and other agencies.
• Perform intermediate mathematical calculations.
• Maintain confidentiality of all applicant and recipient information.

Minimum Qualifications

A four (4) year combination of education, training, and/or progressively responsible experience a social services setting which demonstrates interviewing and data gathering skills as needed to form basis for judgments in eligibility determinations, claims resolutions, and/or customer service requests- OR - a Bachelors Degree in Social Services, Business Administration, or other related field

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) is responsible for administration of eligibility determination for a number of programs, including MaineCare, Temporary Assistance for Needy Families (TANF), Food Supplement, Fraud and Recovery, and Child Support.

Application Information

For additional information about this position please contact Marcus Hatch at [phone] or by email at [e-mail]

To request a paper application, please contact [e-mail]

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 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 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.

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.

If you are unable to complete the online application, please contact the Human Resources representative listed on the job opening you are interested in applying for. They will work with you for an alternative method of submitting.

Create Account Please note: applicant accounts cannot be deleted once created.

If you would prefer not to maintain an online account, you may submit a paper application as an alternative. For information on how to access the paper application, please visit: Application Process About Us