MaineCare Policy Planner

Location: Augusta,Maine,United States

Department of Health and Human Services (DHHS)

Comprehensive Health Planner II

Opening Date: October 21, 2024

Closing Date: November 1, 2024    

Job Class Code: 5050
Grade: 26 (Pro. & Tech. Svcs.) 
Salary: $56,264.00 - $78,998.40 per year

Position Number: 02000-4108

Location: Augusta

(This position is eligible for partial telework with management approval)

Core Responsibilities:

As a Comprehensive Health Planner II in the Policy Division, the Policy Planner will help OMS adopt policies necessary for implementation of its plan for comprehensive rate system reform, which aims to streamline, rationalize and improve MaineCare’s reimbursement system to ensure rates are equitable and sufficient to provide all MaineCare members with access to needed, high value healthcare services. The Policy Planner will develop expertise in covered services as outlined in assigned sections of the MaineCare Benefits Manual (MBM) and in MAPA processes. They will work collaboratively with other OMS staff, DHHS Offices, the Office of the Attorney General, and external stakeholders, including members and providers, to understand the way these sections work in practice, research best practices and legal requirements, recommend changes and updates, and enact changes through rulemaking. This position may work with and actively collaborate on all sections of the MBM.

The Policy Planner will:
•    Draft and propose new rules, working with various internal and external stakeholders.
•    Initiate formal MaineCare policy rulemaking through the MAPA process, including proposal and adoption of MaineCare rules, facilitating public hearings as necessary, and responding to public comment on proposed rules.
��    Evaluate and interpret assigned sections of the MBM, including analysis of standard and best practices nationally and compliance with applicable state and federal laws.
•    Evaluate ways to further OMS’s rate reform goals, including a focus on supporting evidence-based practices.
•    Work collaboratively with a wide variety of stakeholders including internal staff, other state offices, providers, members, and advocates.
•    Think critically and strategically to address complex health policy issues and manage multiple priorities simultaneously.

The position works to create policy that is responsive to the needs of MaineCare members and providers as guided by best practice, data analysis, and stakeholder feedback. The position requires effective communication, including strong analytical and writing skills, presentation delivery and public hearing facilitation, and the ability to work collaboratively with diverse groups and agencies.

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.  Preference will be given to candidates with professional experience researching, interpreting, and writing policy at the program, local, state, or federal level.

Applicants must include a resume and cover letter with their application.

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.
•    Knowledge of Alternative Payment Models and value-based purchasing. 

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

1.    Experience with the analysis, development, interpretation and/or implementation of policy and programs.

2.    Knowledge of health care benefit programs (e.g. MaineCare, other state Medicaid, or private insurance coverage) and relevant issues facing the health care field and health care consumers.

3.    Strong analytic and problem-solving skills.

4.    Knowledge of Medicaid policy, including but not limited to, coverage, reimbursement, eligibility, and/or systems.  

5.    Demonstrated writing, editing and proofreading skills, including the ability to simplify and summarize technical language and complex subject matter in a concise manner and in alignment with plain language principles. (please provide a writing sample)