Rate Setting Manager

Requirements

• 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:
• Extensive knowledge of Medicaid programs, policies, and operations
• Experience effectively leading a team of individuals with different roles, backgrounds, and perspectives to work toward achieving the organization's goals, including contracted vendors.
• A proven ability to analyze complex quantitative data and translate analyses into concise and understandable reports and recommendations.
• Experience managing contracts and working effectively with vendors.
• An established record of managing complex fiscal issues with successful outcomes.
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• Agency information:
• The Rate Setting unit is located w

Benefits

Additional Information

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) 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.

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