OHIM Carrier Relations and Enrollment Specialist

at State of Maine, Bureau of Human Resources in Portland, Maine, United States

Job Description

OHIM Carrier Relations and Enrollment Specialist

Portland , Maine , United States | Community & Social Services | Full-time | Partially remote Apply by: March 12, 2024 Apply with Linkedin Apply

Department of Health and Human Services (DHHS)Comprehensive Health Planner IIOpening Date: February 28, 2024Closing Date: March 12, 2024Job Class Code: 5050

Grade: 26

Salary: $54,620.80-$73,756.80 Position Number: 02000-4079Location: Portland

Core Responsibilities:

OHIM seeks a Carrier Relations and Enrollment Specialist that will support the Consumer Experience Manager and the Carrier Relations and Enrollment Manager in case management work. The position will perform casework that is escalated from the Consumer Assistance Center and numerous health insurance carriers. A core component of this role is to perform monthly carrier reconciliation to resolve all Marketplace enrollment discrepancies and work with the carriers to resolve their discrepancies. This position will report directly to the Carrier Relations and Enrollment Manager. Other duties include:

- Performing consumer casework related to eligibility and enrollment;

- Serving as a liaison to the health insurance carriers on;

- Comparing and analyzing large sets of complex data;

- Working with the carriers to complete annual plan, benefit, rate testing;

- Assisting in User Acceptance Testing (UAT) for defects, system enhancements, features, and functionality;

- Other duties as assigned.

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. Experience in customer service, data analysis, program evaluation or health care or insurance programs or services is highly preferred.

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 lived experience and passion set you apart.

Agency information:

TheDepartment 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, Maine’s Health Insurance Marketplace. Following a successful implementation executed in under 12 months, completed its first Open Enrollment period with nearly an 11% increase in plan selections from the prior year. 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. Position is located in Portland, Maine. (Flexibility for remote work within the State of Maine available).

Application Information:

Please submit all documents or files in PDF format. For additional information about this position please contact Desirea Murray at (207) 441-0465 or by email To apply, please upload a recent resume and a cover letter addressing your qualifications for this position. To request a paper application, please contact ( .


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 ($10,523.28-$12,380.40 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 13.41 % 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-receivesix 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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Job Posting: JC256085710

Posted On: Mar 01, 2024

Updated On: Mar 15, 2024

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