Eligibility Specialist I

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) Opening Date:
August 7, 2026 Closing Date:
August 20, 2026 Job Class Code: 5075 Grade: 18 (Professional & Technical Services) Salary: $19.02 - $26.48 per hour
* * New State employees begin at Step 1, $19.02 per hour

Location:

Houlton This opening is a hybrid position with a partial in office requirement. Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

As an Eligibility Specialist I, you'll play a vital role in connecting Maine residents to the health coverage they need through Maine Care - the state's largest health insurance program serving lower-income adults, children, older adults, and people with disabilities. In this position, you'll help people navigate important life situations while ensuring accuracy in determining eligibility. The work is fast-paced, collaborative, and mission-driven with a strong focus on customer service, problem solving, and teamwork.

• Evaluate information and apply program standards to accurately determine Maine Care eligibility and benefits.
• Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.
• Clearly explain Maine Care rules, requirements, and decisions to applicants and members - both in writing and over the phone.
• Review and process information received electronically or by mail to ensure completeness and compliance.
• Connect individuals with additional programs and services that may support their health and well-being.

Strong communication and interpersonal skills are essential as you'll work with people from diverse backgrounds, with varying needs, and help them navigate complex systems during moments that matter.

To qualify for this position, you must have a two (2) year combination of training, education, and/or experience in a health or human services setting which demonstrates competency in applying policies and rules to make decisions, maintaining and verifying digital records, and/or responding to client requests.

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) connects Maine people and families to services and programs that foster health, safety, resilience, and opportunity including Maine Care (Medicaid), the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and other education and career programs.

• 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…