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Community Engagement Eligibility Specialist

LanceSoft, Inc.

Key Facts

Remote From: 
Maine (USA)
Full time
English

Other Skills

  • •
    Microsoft Office
  • •
    Non-Verbal Communication
  • •
    Decision Making

Roles & Responsibilities

  • Competency in applying a solid knowledge of the principles and practices of quality customer service to perform complex work in assisting the public with applications, fees, examinations, or social services that have an eligibility or compliance component
  • The ability to use independent decision-making on the appropriate processes to follow, information to process, and actions to take in accordance with standard procedures
  • Skilled in Microsoft Office suite of programs
  • Skilled in telephone communication with clients/the public and using telephony system

Requirements:

  • Work MC case updates; to include data entry in the OFI eligibility systems; applying relevant program policies to specific case circumstances, and identifying and requesting verifications
  • Updating client information in Automated Client Eligibility System (ACES), including outreach by phone or otherwise
  • Fielding and/or conducting phone calls to/from the public to answer basic questions, provide information about case status, or triage to eligibility specialists if needed
  • Additional MC eligibility work that supports Client readiness

Job description


Job title: Community Engagement Eligibility Specialist
Start Date: April 13, 2026
End Date: April 2028
Location: DHHS Office/Location Office for Family Independence (OFI), Augusta ME 04333

An overview of the work, briefly summarizing the job, the main purpose, the objectives, and the results expected.
  • The positions will provide critical support to OFI’s Community Engagement (Client) eligibility function and outreach.
  • Those functions will include navigating various state systems to do data entry and analysis and correspond with clients in writing and on the phone as needed.
  • The main purpose is to ensure compliance with PL 119-21 establishing Client requirements for Medicaid expansion enrollees with approximately 85,000 MaineCare (MC) members subject to these requirements. These resources will process MC updates and provide outreach to increase the number of people who can be passively renewed for MaineCare, decreasing the overall workload for OFI Eligibility Specialists, with a goal of meeting federal Client requirements by January 1, 2027. Additionally, OFI looks to ensure individuals remain in compliance and minimize administrative burden on members

Knowledge, Skills and Certifications:
  • Specific qualifications needed to perform the job including, necessary licenses, knowledge, skills, education, experience, training, and technical skills.
  • Competency in applying a solid knowledge of the principles and practices of quality customer service to perform complex work in assisting the public with applications, fees, examinations, or social services that have an eligibility or compliance component
  • The ability to use independent decision-making on the appropriate processes to follow, information to process, and actions to take in accordance with standard procedures
  • Skilled in Microsoft Office suite of programs
  • Skilled in telephone communication with clients/the public and using telephony system

Duties and Deliverable (Outline of specific job duties):
  • Specific duties required of the resource, as well as any expected deliverables, including necessary travel expectations.
  • Work MC case updates; to include data entry in the OFI eligibility systems; applying relevant program policies to specific case circumstances, and identifying and requesting verifications
  • Updating client information in Automated Client Eligibility System (ACES), including outreach by phone or otherwise
  • Fielding and/or conducting phone calls to/from the public to answer basic questions, provide information about case status, or triage to eligibility specialists if needed
  • Additional MC eligibility work that supports Client readiness

Schedule:
  • Summary of work schedule, including normal working hours, on-call expectations, allowed time off (which is non-billable), ability to work remote.
  • This will be a fully remote, full-time role, with hours expectations aligning with Department staff – eight working hours on a set schedule that can start as early as
  • 7:00 a.m. and go until no later than 5:00 p.m., with 30 or 60 minutes for lunch.
  • This is a 40-hour per week position, and no overtime will be permitted.
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