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