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Rate Setting Manager

State of Maine

Augusta, Maine

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JOB DETAILS
SALARY
$71,843.20–$101,587.20
SKILLS
Actuarial Skills, Analysis Skills, Business Administration, Claims Processing, Contract Management, Cost Analysis, Data Analysis, Department of Health and Human Services, Financial Analysis, Financial Management, Healthcare Providers, Hospital, Leadership, Medicaid, People Management, Procedure Development, Process Improvement, Psychiatry and Mental Health, Public Health, Public Policy, Quantitative Analysis, Regulations, Reimbursement, Systems Analysis, Team Lead/Manager
LOCATION
Augusta, Maine
POSTED
1 day ago
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 of Health and Human Services (DHHS)

Public Service Manager II

Opening Date: June 24, 2026

Closing Date: July 8, 2026

Job Class Code: MA30

Grade: 30 (Confidential)

Salary: $71,843.20 - $101,587.20 per year

Position Number: 02022-8072

Location: Augusta

Core Responsibilities:

The Rate Setting Manager supports the ongoing implementation and operations of a comprehensive, streamlined, and coherent system of reimbursement for MaineCare services and programs. This role will provide leadership to the Rate Setting team, working to maintain and improve processes and procedures.

This role's responsibilities will include:

• Supervise and provide guidance to unit staff members who administer rate setting processes for MaineCare's claims processing system, MIHMS.

• Be responsible for ensuring that rates established for MaineCare programs and services are properly entered into MIHMS.

• Provide cost analyses and subject matter expertise for services contracted by the Department, which will be used to determine reimbursement rates and methods.

• Provide fiscal analyses of departmental costs associated with reimbursement for MaineCare and other DHHS programs.

• Review proposed legislation and prepare fiscal estimates related to this legislation. Implement adopted legislation or regulations.

• Provide contractual oversight for vendors performing the rate system evaluation, rate assessments, and actuarial analysis of rates and savings payments within specific initiatives.

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, Public Policy, or closely related field AND two (2) years of responsible experience in quantitative 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

• Experience as a direct supervisor

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

1. Extensive knowledge of Medicaid programs, policies, and operations

2. Experience effectively leading a team of individuals with different roles, backgrounds, and perspectives to work toward achieving the organization's goals, including contracted vendors.

3. A proven ability to analyze complex quantitative data and translate analyses into concise and understandable reports and recommendations.

4. Experience managing contracts and working effectively with vendors.

5. An established record of managing complex fiscal issues with successful outcomes.

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.

About the Company

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State of Maine