OHIM Carrier Relations and Enrollment Specialist

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)

Comprehensive Health Planner II

Opening Date: April 3, 2026

Closing Date: April 16, 2026

Job Class Code: 5050

Grade: 26

Salary: $56,264.00 - $78,998.40 per year

Position Number: 02000-4079

Location: Portland

This position allows for partial telework with management approval.

Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

Make an impact on access to health coverage in Maine.

OHIM is seeking a detail-oriented and collaborative Carrier Relations and Enrollment Specialist to play a key role in ensuring accurate Marketplace eligibility determinations, seamless enrollments, and strong partnerships with health insurance carriers.

Core Responsibilities:

In this role, you will serve as a critical liaison between the Marketplace and participating health insurance carriers. Key responsibilities include:

• Manage eligibility and enrollment casework, resolve escalated Marketplace applications and enrollments to ensure accurate consumer outcomes
• Support monthly carrier reconciliation processes, identifying, analyzing, and resolving enrollment discrepancies across systems
• Build and maintain strong carrier relationships, working directly with health insurance partners to troubleshoot issues and ensure alignment
• Analyze complex datasets to identify trends, inconsistencies, and opportunities for process improvement
• Support annual plan, benefit, and rate validation/testing in collaboration with carriers
• Participate in User Acceptance Testing (UAT) for system enhancements, defect resolution, and new functionality
• Serve as a key contributor to continuous improvement efforts across eligibility, enrollment, and carrier operations.

 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.

Preferred experience includes:

• Experience with carrier reconciliation, enrollment auditing, or resolving data discrepancies between systems and external partners
• Familiarity with insurance eligibility systems and processes, including eligibility rules, plan selection, and effectuated enrollment workflows
• Experience with eligibility and/or enrollment casework for federal, state, or health and human services programs (e.g., Medicaid, Health Insurance Marketplace, SNAP, TANF).

Thinking about applying? We welcome candidates with strong analytical or casework experience even if you don’t have prior carrier reconciliation experience – full training is provided.

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 Maine DHHS Office of the Health Insurance Marketplace (OHIM) operates CoverME.gov, Maine’s Health Insurance Marketplace. OHIM is a small, dynamic team driven by the dual missions of optimizing consumer experience and increasing enrollment in health coverage among eligible populations. Successful candidates will be team players who thrive in a fast-paced environment and share a commitment to ensuring that all Mainers can access quality, affordable health insurance coverage.

Application Information:

For questions about this position, please contact Laurie Stinson at 207-441-1392, or Laurie.Stinson@Maine.gov

Please submit all documents or files in PDF or Word format.

To request a paper application, please contact Lucia.Nadeau@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 package, including:

• Work-Life Fit – 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 ($12,845.82 - $15,112.76 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 ($395.72 annual value). 
• Retirement Plan – The State contributes the equivalent of 14.11% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).
• Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing and adoptive parents—receive six weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act.

State employees are eligible for an extensive and highly competitive benefits package, covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.

Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for anything less than full-time.

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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If you are unable to complete the online application, please contact the Human Resources representative listed on the job opening you are interested in applying for. They will work with you for an alternative method of submitting.