Eligibility Specialist II - Long Term Care

MaineGuide; Northern (KY); Hybride; USD 31 000 - 43 000; Plein temps

Avantages offerts par ce poste

13 paid holidays

3+ weeks vacation leave

Health Insurance Coverage

Dental Insurance

Retirement Plan

Gym Membership Reimbursement

Flexible Spending Accounts

Résumé du poste

MaineGuide is seeking an Eligibility Specialist II to determine initial and continued eligibility for public assistance programs, with a strong focus on MaineCare policy. You will gather sensitive information and interview clients to ensure timely and accurate eligibility determinations in a fast-paced environment.

This role requires excellent interpersonal and conflict-resolution skills, meticulous data verification, and strict confidentiality.

Qualifications

• Four-year combination of education, training, and/or progressively responsible experience in a social services setting.
• Bachelor's Degree in Social Services, Business Administration, or related field.
• Strong interviewing and data gathering skills.
• Ability to maintain confidentiality of sensitive information.

Responsabilités

• Interview clients and gather facts and documentation for eligibility.
• Evaluate information against program rules and criteria.
• Explain eligibility requirements and rights to clients and representatives.
• Verify data accuracy and resolve inconsistencies; request documents.

Connaissances

Interviewing

Data gathering

Communication

Customer service

Confidentiality

Mathematical calculations

Formation

Bachelor's degree or four-year combination

Description du poste

Eligibility Specialist II

Opening Date: October 9, 2026

Closing Date: October 23, 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: 02022-7687

Location:Machias

This position allows for partial telework with management approval.

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

Core Responsibilities:

The 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.

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 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 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 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 for anything less than full-time.

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.