- Salary
- $56k – $79k
- Location
- 109 Capitol Street, Augusta, United States of America
- Type
- Full-time
- Department
- Healthcare
- Closing date
- Today
- Source
- Workday
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)
Comprehensive Health Planner II
Opening Date: August 13, 2026
Closing Date: August 26, 2026
Job Class Code: 5050
Grade: 26 (Pro. & Tech. Svcs.)
Salary: $56,264.00 - $78,998.40 per year
Position Number: 20002-5210
Location: This position is located in Augusta. Occasional travel is required.
-Limited Period Position-
Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.
Core Responsibilities:
As a Comprehensive Health Planner II, you will review and implement algorithms using computer systems designed for measuring and monitoring utilization of MaineCare covered services and identifying potential areas of fraud and abuse. You will conduct independent and complex compliance and/or programmatic audits/reviews of MaineCare providers and programs that receive state and federal funds from the Department of Health and Human Services. These audits are required to ensure compliance with established laws, rules, regulations and standards. In addition, you will be responsible for maintaining the Division’s required federal reports. To successfully perform these duties, you must have the ability to comprehend and analyze complex MaineCare policies and procedures, the related healthcare claims, medical and clinical healthcare records, and budget and expenditure information. You must be highly skilled with standard desktop technology, particularly spreadsheet and database applications. You must be detail oriented, able to work independently and possess a high level of initiative. As a Comprehensive Health Planner II you will contribute to the Department’s mission and goals by helping to ensure public assistance funds are utilized for the purposes enacted in legislation.
Minimum Qualifications:
A Bachelor’s Degree in Public/Community Health, Health Administration, Health Sciences or Health Education; Public Administration, Government, Social Work, or a closely related field and three (3) years professional experience in the planning, development, coordination and/or evaluation of health programs or services -OR- an equivalent seven (7) year combination of education, training, and experience.
The background of well-qualified candidates will demonstrate the following:
• Knowledge/experience in healthcare and claims research analysis;
• Knowledge/experience using spreadsheet and database applications;
• Knowledge/experience in auditing/reviewing healthcare related services;
• Knowledge/experience in utilizing nationally accepted billing forms and coding.
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 Department of Health and Human Services (DHHS) provides supportive, preventive, protective, public health and intervention services that safeguard the public health and assist our customers in meeting their needs. The Program Integrity Unit in the Office of MaineCare Services is responsible for providing audit oversight services of public assistance funds administered by the MaineCare Program.
Application Information:
For questions about this position, please contact Valerie Hooper at 207-287-2414
Please submit all documents or files in PDF or Word format.
To request a paper application, please contact [email protected]
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 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.
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.
.
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.