Case Manager

Requirements

• The background of well-qualified candidates will demonstrate the following competencies:
• Knowledge of healthcare coverage programs (e.g., private insurance, MaineCare or Medicare).
• Strong verbal and written communication skills.
• Ability to use independent judgment, initiative, and discretion to problem solve and make determinations on varied matters.
• Ability in providing kind, courteous, and exceptional customer service.
• 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 Maine DHHS Office of the Health Insurance Marketplace (OHIM) operates CoverME.gov, Maine's Health Insurance Marketplace.
• Application Information:
• For additional information about this position please contact Amanda.Alley@Maine.gov
• To apply, please upload a recent resume (if available) and cover letter addressing each of the preferred skills/experience areas above.
• Please submit all documents or files in PDF or Word format.
• To request a paper application, please contact Mandy.Hernandez@Maine.gov
• Benefits of working for the State of Maine:
• 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 packag

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) Comprehensive Health Planner II Opening Date: June 8, 2026 Closing Date: June 22, 2026 Job Class Code: 5050 Grade: 26 (04) Salary: $56,264.00 - $78,998.40 per year Position Number: 20002-4950 Location: Portland -Limited-Period Position- This is a full-time, limited-period position located in our Portland office. This position allows for partial telework with management approval. Core Responsibilities: OHIM seeks a Case Manager that will support the operations team in case management work. The position will perform casework that is escalated, primarily from the Consumer Assistance Center. This position will also play a supporting role in user acceptance testing of the changes to the eligibility and enrollment platform. The position will monitor the service provided, evaluating the data that comes from client interactions, to aid in planning and policy development. This position will report directly to the Consumer Experience Manager. Other duties include: - Monitor non-routine consumer related work regarding eligibility and enrollment. Utilize the internal policy manual to recommend decisions, when relevant; - Provide casework support for escalated cases from brokers and Maine Enrollment Assisters (MEAs). Provide results and feedback to broker and navigator program coordinator so she can communicate findings and recommendations to brokers, MEAs and navigators. - Discuss health insurance issues with appropriate senior manager in order to ensure the accuracy and credibility of insurance enrollments; - Organize and write plans, decision documentation, and other documents in order to provide information. Present and explain reports to various groups in order to increase understanding and achieve support for conclusions; - Assist in identifying areas of opportunity for consumer and stakeholder education based on frequent types of escalated cases. Communicate these opportunities to consumer communication team. - Assist in User Acceptance Testing (UAT) for defects, system enhancements, features, and functionality; - Other duties as assigned.

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