MaineCare Medical Director

State of Maine; Augusta (ME); On-site; USD 179,000 - 255,000; Full time

Benefits offered by this job

Health insurance

Retirement plan

Parental leave

Gym membership reimbursement

Job summary

The State of Maine's Department of Health and Human Services is seeking a Public Service Coordinator III in Augusta. This senior role provides clinical leadership for MaineCare, guiding policy and programs to improve health outcomes for MaineCare members and prioritize value-based care.

The position leads the Care Coordination Division, supervises clinical staff, and partners with internal teams and external providers to promote high-quality, equitable care across Maine.

Qualifications

• Senior leadership experience in a large health organization.
• Experience with Medicaid/ MaineCare preferred.
• Strong communication and collaboration across multiple teams.

Responsibilities

• Provide clinical leadership for MaineCare program.
• Lead development and oversight of policy and programs.
• Supervise Care Coordination Division and liaise with OMS/DHHS leadership.

Skills

Leadership

Strategic thinking

Communication

Collaboration

Education

MD or DO or NP or PA degree

Active Maine license

Board certification

Job description

Department of Health and Human Services (DHHS)

Public Service Coordinator III

Opening Date: October 13, 2026

Closing Date: October 26, 2026

Job Class Code: CA62

Grade: 62 (Confidential)

Salary: $179,129.60 - $254,654.40 per year

Position Number: 20002-5275

Location: Augusta

Limited Period Position

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

Core Responsibilities

The MaineCare Medical Director is responsible for providing clinical leadership and guidance for the MaineCare program to support MaineCare goals and objectives and in alignment with MaineCare priorities, as established in coordination with the MaineCare Director and the Commissioner’s Office of the Department of Health and Human Services (DHHS). The Medical Director supports development, implementation, and operations of policy, programs, and initiatives that aim to improve health outcomes for MaineCare members, achieve improved health outcomes for all populations served by MaineCare, and promote high value care. The Medical Director directly communicates with healthcare providers in the state, participates in relevant advisory groups, sponsors or leads certain initiatives to improve internal care coordination functions as well as to reform the broader external delivery system, and, when needed, interacts with the state legislature at the direction of the Office of MaineCare Services (OMS) and DHHS leadership.

This position will be a member of the OMS Senior Management Team. In that capacity, the position will serve as a senior level liaison to other teams within and outside OMS, promote cross-team collaboration and communication, contribute to budget and legislative planning, advise senior and executive leaders, and provide updates on project progress and advancements of key priorities. To accomplish this, the person in this position must understand how the teams’ work is connected to the work of other teams within OMS and other state agencies. As a senior leader within the office, this position must be able to understand, professionally and confidently represent, and promote the work, values, and priorities of the division, Office, and Department to both internal and external audiences. The person in this position must be able to think critically and creatively, be solution-oriented, take a high degree of initiative, show good judgment, and work under minimal supervision.

The position will supervise one direct report, the Care Coordinator Manager, and over 30 indirect reports, both clinical and non-clinical, across five teams/areas of the Care Coordination Division (Prior Authorization, Complex Case Unit, Emergency Department Collaborative, HIV Waiver, and VitalCare for Kids (EPSDT)). These teams work with and on behalf of MaineCare members who have complex medical needs to support their ability to access timely critical services.

Key Priorities for this position include

• Ensuring that OMS coverage policies are well-grounded in clinical evidence and well-positioned to effectively serve all MaineCare members
• Supporting the advancement of MaineCare’s focus on value-based care and alternative payment models
• Providing clinical leadership and oversight to improve the effectiveness of care coordination and utilization management for high-need MaineCare members provided by MaineCare staff, external vendors and through healthcare delivery system initiatives
• Collaborating with MaineCare and DHHS analytics, research and evaluation teams to help direct and interpret efforts to identify and address areas of health disparities

Typical responsibilities and duties include

• Supervising teams to ensure that work is appropriately assigned, prioritized, scheduled, and executed in accordance with agreed upon plans and supporting direct reports to learn and grow
• Assisting with the development of quality standards and performance measures to assess provider performance and member health outcomes
• Assisting with the development of and, in certain cases, sponsor or lead MaineCare strategic initiatives to promote delivery system reform and/or the elimination of health inequities
• Supporting Maine’s Medicaid program through participation in national leadership and learning opportunities to inform and stay current on Medicaid best practices and foster state to-state learnings, including Medicaid Medical Director networks, national technical assistance opportunities, and presentations at local and national meetings
• Participating in DHHS cross-office initiatives that require input from the MaineCare Medical Director
• Providing clinical guidance on day-to-day MaineCare operations, projects and grant applications
• Participating as a member of MaineCare senior leadership
• Representing OMS and DHHS to internal and external stakeholders, including, but not limited to, other DHHS offices, MaineCare providers, advocacy associations and organizations, and MaineCare vendors

This position reports to the MaineCare Director.

Minimum Qualifications

• Medical degree (MD or DO) from an accredited school of medicine; OR a Master of Nursing from an accredited school of nursing; OR a Master of Science, Physician Assistant, from an accredited university
• Active State of Maine medical, nurse practitioner, or physician assistant license
• Relevant board certification
• Minimum of five (5) years of direct patient care experience, and relevant medical knowledge, with particular experience in adult primary care for Medicaid-eligible populations
• Lived experience with Medicaid and/or other health-related social needs common to individuals and families receiving Medicaid coverage
• Direct experience with and knowledge of the Medicaid program, other health and human services programs serving low-income populations, and populations served, with an emphasis on populations with complex needs (e.g. members experiencing homelessness, with substance use disorder, serious mental illness, comorbid and complex medical conditions)
• Prior experience in medical leadership, in a management or supervisory role (e.g. practice or organizational Medical Director) within a large, complex organization, working with cross-functional teams, including operations
• Advanced training or experience in health care management, public health, public policy, and/or business administration
• Prior experience in the analysis, interpretation, development, and implementation of policy, programs and data predominantly benefiting lower income populations at the state or federal level
• Ten (10) or more years of direct patient care experience, and relevant medical knowledge, with particular experience in adult primary care for Medicaid-eligible populations

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

• Leadership skills necessary to problem solve, make decisions, and envision and articulate change to address complex clinical, compliance, policy, and operational issues and goals
• Capacity to balance and negotiate between multiple, changing priorities
• Proven ability and motivation to effectively develop and/or manage multiple short- and long-term projects with diverse interested parties and partners internal and external to the team and agency
• Ability to be data driven, with a working knowledge of medical coding, claims and interpretation of data analysis
• Solid written and oral communication and presentation skills, including the ability to articulate issues in a concise manner that is understandable to a wide range of audiences
• Effective interpersonal influence, collaboration, team building and conflict management skills

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.

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 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 for anything 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.