Comprehensive Health Planner II
Opening Date: September 18, 2023
Closing Date: October 2, 2023
Job Class Code: 5050
Grade: 26 (Pro. & Tech. Svcs.)
Salary: $51,521.60 - $69,576.00 /yr.
Position Number: 02031-2417
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 sections of the MBM relating to children’s and behavioral health services, including crisis services, private non-medical institution services, assertive community treatment services, and rehabilitative and community support services.
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, Public Policy, Law/Legal Studies, Social Work, or a closely related field and three (3) years professional experience in the planning, development, coordination and/or evaluation of health programs, services, or policy -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.
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. 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)
5. The ability and motivation to effectively manage multiple long- and short-term projects with diverse stakeholder groups.
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 health insurance coverage for low-income families, adults and children so they can access the important health care services they need to be healthy and be a part of the community through work, caring for family, going to school, and more. OMS works collaboratively within DHHS, with other Departments and the Office of the Governor, with MaineCare members, with providers, and with other health care purchasers on statewide healthcare improvement initiatives. OMS is committed to advancing health equity efforts to improve access to care and health outcomes for all low-income Mainers. OMS provides benefit coverage and supports the services that operate in alignment with Department goals, federal mandates, and State policy. OMS also provides oversight necessary to ensure accountability and efficient and effective administration.
The Policy Division is responsible for the development of policies and programs that provide eligible Maine residents with access to comprehensive, affordable, evidence-based health care services. The unit has primary responsibility for planning, writing, and promulgating administrative rules related to MaineCare covered services through formal rulemaking consistent with the Maine Administrative Procedure Act (MAPA).
Application Information:
Please submit all documents or files in PDF format.
For questions about this position, please contact Henry Eckerson at 624-4085
To request a paper application, please contact Ashley.Smith@Maine.gov .
Benefits
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 Balance – Rest is essential. Take time for yourself using 13 paid holidays, 12 days of sick leave, and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.
- Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($10,150.80-$11,942.16 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 ($350.40 annual value).
- Retirement Plan – The State of Maine contributes 13.16% of pay to 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 fathers and adoptive parents—receive four 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.
- Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.
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.
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