Rate Setting Data Specialist

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Department of Health and Human Services (DHHS)
Management Analyst II
Date: October 9, 2026
Closing Date: October 23, 2026
Job Class Code: 0393
Grade: 24 (Professional & Technical)
Salary: $56,888.00 - $79,768.00 per year
Position Number: 20002-5200
Location: Augusta
This position allows for partial telework with management approval.
Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.
Core Responsibilities:
The Rate Setting Data Specialist assists in research, data collection, data analysis, document creation, coordination, and task tracking. The primary function of this position would be to assist and provide support to the Rate Setting Financial Analysts and broader Data Analytics team. This includes researching reimbursement rates for MaineCare as well as healthcare reimbursement rates from other State Medicaid Agencies, Medicare, and Commercial Insurance calculations. Additionally, this position would assist in Quality Assurance for all documents that are created both internal and external facing for accuracy.
This role’s responsibilities will include:
Collect data publications used in the rate methodologies implemented by the Department including CMS fee schedules in which some MaineCare rates are benchmarked.
Perform data collection, data extraction, and data analysis of healthcare rates and reimbursement.
Create fee schedule documents to be posted on the Provider Portal for reference.
Create and maintain historic data files related to reimbursement rates and changes to those reimbursement rates.
Provide Quality Assurance review of documents to help ensure the quality of the documents produced.
Help maintain Quality Assurance protocols and checklists.
Create letters of reimbursement for special agreements with providers to provide certain services.
Create informational dashboards based on healthcare data to inform of trends and decision making.
Minimum Qualifications:
To qualify, you must have an eight (8) year combination of education and/or experience analyzing, evaluating, and/or presenting data findings to aid in meeting organizational objectives and informing leadership during decision-making.
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
The background of well-qualified candidates will demonstrate the following competencies:
Proficiency with Microsoft Word and Microsoft Excel.
Data analysis skills and the utilization of critical thinking skills when evaluating data sets.
Ability to process data to form an analysis and describe and discuss that analysis clearly.
A history of showing curiosity and a desire to learn new topics thoroughly.
An established history of working in a team-focused environment.
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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 free or low-cost health insurance coverage for low-income Mainers so they can access the health care services they need to work, care for family, go to school, and participate in the community. OMS works collaboratively with other State agencies, the Legislature, the Office of the Governor, MaineCare members, health care providers, and other health care purchasers on statewide healthcare improvement initiatives. OMS is committed to advancing health equity efforts to improve access to care and positive health outcomes for all low-income Mainers. OMS provides benefit coverage and support services in alignment with Department goals, federal requirements, and State statutes. OMS also provides oversight necessary to ensure accountability and efficient and effective administration of the state’s Medicaid program.
The Rate Setting unit is located within the OMS Data Analytics team. Rate Setting oversees the implementation and operations of MaineCare’s award-winning rate system reform efforts and other key DHHS reimbursement initiatives. Rate Setting objectives are to streamline, rationalize, and improve MaineCare’s reimbursement system to ensure rates are equitable and adequate to provide all MaineCare members with access to needed, high value healthcare services. For more information on MaineCare’s rate reform efforts, please visit: www.mainecare.gov/rate-reform.
Application Information:
For additional information about this position please contact Corey Ballew @ 207-830-1949.
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 package, including:
Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave. When you or immediate members of your family are ill, utilize 12 days of sick leave per year.
Health Insurance Coverage – The State of Maine pays 85%-95% of employee-only premiums ($12,213.60 - $13,650.48 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 ($365.28 annual value).
Retirement Plan – The State contributes the equivalent of 14.06% of the employee's pay towards 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 – Navigat