Rate Setting Financial Analyst

State of Maine; Virginia (MN); Hybrid; USD 66,000 - 94,000; Full time

Benefits offered by this job

Health Insurance Coverage

Health Insurance Premium Credit

Dental Insurance

Retirement Plan

Gym Membership Reimbursement

Flexible Spending Accounts

Public Service Student Loan Forgiv-

Job summary

State of Maine, Department of Health and Human Services (DHHS) is hiring a Rate Setting Financial Analyst in Augusta. The role involves researching cost data, producing annual fee schedules, and analyzing financial impacts of rate changes for MaineCare.

The position requires a Master’s Degree in Business Administration, Non-Profit Administration, Finance, or related field and two years of cost/financial analysis experience. Partial telework is allowed with management approval.

Qualifications

• Eight-year combination of education and/or experience comprising a Master’s Degree plus two years of cost, budget, and financial analysis experience.
• Directly related professional experience may be substituted for education on a year-for-year basis.

Responsibilities

• Research and analyze cost and financial data from various sources to determine rates and cost charges for services.
• Produce updated fee schedules annually or as rates are updated.
• Create fiscal impact analyses of potential rate changes, provider rate requests, and legislative changes for MaineCare reimbursement.
• Create rate letters when reimbursement methods indicate appropriate provider-specific rates.
• Provide DHHS administration with analysis of reimbursement rates for MaineCare and other programs.
• Collaborate with OMS Policy, Provider Relations, Care Coordination, Delivery System Reform, and OMS units to develop rate-setting methodologies.
• Determine financial impact to the Department regarding proposed payment changes.
• Supervise and cross-train Rate Setting staff.
• Participate in rate model reviews and Alternative Payment Methodologies.
• Act as subject matter expert on rate models as part of Rate Reform.
• Cover meetings when the Manager of Rate Setting is unavailable.

Education

Master’s Degree in Business Administration, Non-Profit Administration, Finance, or closely related field

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.

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Department ofHealth and Human Services (DHHS)

Public Service Coordinator I

Opening Date: July 31, 2026

Closing Date:August 13, 2026

Job Class Code:CA28

Grade:28 (Confidential)

Salary:$66,206.40 - $94,057.60 per year

Position Number:02031-2525

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:

As a Rate Setting Financial Analyst, you will:

• Research and analyze cost and financial data from various sources and determine appropriate rates and cost charges for services.
• Produce updated fee schedules on an annual basis, or on an ad hoc basis as rates are updated.
• Create fiscal impact analysis of potential annual rate changes, provider rate requests, and Legislative bills for changes in MaineCare Reimbursement.
• Create rate letters when a reimbursement methodology indicates that provider-specific rates are appropriate.
• Be responsible for providing DHHS administration with analysis of reimbursement rates associated with MaineCare and other Department programs.
• Work with program staff from OMS Policy, Provider Relations, Care Coordination, Delivery System Reform, and other OMS units, and also from other DHHS Offices, to develop and implement rate-setting methodologies and assumptions used to develop and authorize payments to providers for services delivered to MaineCare members.
• Be responsible for determining financial impact to the Department regarding proposed changes in reimbursement methods and/or levels.
• Supervise and cross-train other Rate Setting staff.
• Participate in the review and development of rate models and Alternative Payment Methodologies.
• Act as the Department’s subject matter expert on rate models and rate model elements as part of the Rate Reform process.
• Cover meetings when the Manager of Rate Setting is unavailable, acting as a subject matter expert.

Minimum Qualifications:

To qualify, you must have an eight (8) year combination of education and/or experience comprised of a Master’s Degree in Business Administration, Non-Profit Administration, Finance, or a closely related field and two (2) years of experience in cost, budget, and financial analysis. Directly related professional experience may be substituted for education on a year-for-year basis.

Preferred experience includes:

• Experience with and knowledge of the Medicaid program and/or other health and human services programs serving low-income populations.
• Lived experience with Medicaid and/or other health-related social needs common to individuals and families receiving Medicaid coverage.

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

• A thorough knowledge of the Governmental Accounting Standards Board’s Generally Accepted Accounting Principles (GASB/GAAP) evidenced through formal education and practical experience at the professional level.
• An established record of managing complex fiscal issues with successful outcomes.
• Ability to successfully partner with financial and program staff to achieve common goals.
• Ability to research law, regulations, and Medicaid policies to provide sound advice and recommendations to executive managers.

Thinking about applying?

Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you’re currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your experience and passion set you apart.

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.

The Rate Setting unit is located within the OMS Data Analytics team. Rate Setting oversees the implementation and operations of MaineCare’s rate system and other key DHHS reimbursement initiatives. Rate Setting objectives are to streamline, rationalize, and improve MaineCare’s reimbursement system to ensure rates are equitable and adequate to provide all MaineCare members with access to needed, high value healthcare services.

For questions about this position, please contact Dwayne Parsons at 207-287-4875.

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 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 theFamily and Medical Leave Act .
• Voluntary Deferred Compensation – Save additional pre-tax funds for retirement in a MaineSaves 457(b) account through payroll deductions.

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.

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.

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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.