MaineCare Complex Case RN

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Department of Health and Human Services (DHHS)

Health Services Consultant

Opening Date: November 2, 2026

Closing Date: November 16, 2026

Job Class Code: 4381

Grade: 07-22 (Nurses)

Salary: $58,219.20 - $79,331.20 per year

Position Number: 02022-3861

Location: Augusta

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

Core Responsibilities:

As the Complex Case Nurse in the Complex Case Unit (CCU), you will use your clinical expertise to support Maine residents of all ages with complex medical, developmental, behavioral, or psychosocial needs.  You will collaborate with individuals, families, providers, and state agencies to assess needs, coordinate multidisciplinary team meetings, and help develop a clear path toward resolution.  Your work will help individuals navigate complex systems and access appropriate care and services. 

Regular duties include:  

•        Provide information, problem-solving assistance, and support to Maine residents, their families, support networks, and healthcare providers. 

•        Facilitate multidisciplinary team meetings for individuals who lack a discharge plan or face other complex challenges, working with involved parties to identify safe placement options and resolve barriers to care.      

•        Coordinate with statewide service providers, community resources, and internal and external DHHS partners to address complex cases and identify solutions. 

•        Escalate complex cases to middle and senior management and consult with leadership as needed.    

•        Build and maintain collaborative relationships with community agencies, hospitals, healthcare providers, MaineCare members, families, and DHHS offices, including the Office of Behavioral Health (OBH), Adult Protective Services (APS), Children’s Protective Services (CPS), Office of Child and Family Services (OCFS), Office of Aging and Disability Services (OADS), and programs serving individuals with brain injuries or intellectual and developmental disabilities.  

This position reports to the Complex Case Manager. 

Minimum Qualifications:

Registered Nurse and three (3) years of progressively responsible experience in the field of nursing and/or in the delivery of health care services.

LICENSING/REGISTRATION/CERTIFICATION REQUIREMENTS:

Licensed as a Registered Professional Nurse in the State of Maine, as issued by the State Board of Nursing.

Preferred experience includes:

•        2-3 years of clinical pediatric and adult experience, or previous case management experience. 

•        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.  Please address these competencies in your cover letter: 

1.        Knowledge of and experience with individuals of all ages who have complex medical, physical, developmental, behavioral, or mental health needs.

2.        Familiarity with MaineCare, other state agencies, and statewide community resources that support access to healthcare, services, and safe placement options. 

3.        Ability to establish and maintain effective working relationships with MaineCare members, families, guardians, healthcare providers, community partners, and organizations while maintaining objectivity and professionalism.   

4.        Ability to gather and analyze case information, assess complex situations, identify barriers to care, draw sound conclusions, and make informed decisions independently.    

5.        Ability to work independently and as part of a multidisciplinary team to coordinate services, facilitate case discussions, and develop practical solutions to complex challenges. 

6.        Strong critical- thinking, problem-solving, communication, organizational, and time-management skills, with the ability to manage competing priorities and recognize when issues require escalation. 

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 Office of MaineCare Services (OMS) within DHHS administers the state’s Medicaid program, which provides health insurance coverage for low-income families, adults and children so they can access the important health care services they need to be healthy and be a part of the community through work, caring for family, going to school, and more. OMS works collaboratively within DHHS, with other Departments and the Office of the Governor, with MaineCare members, with providers, and with other health care purchasers on statewide healthcare improvement initiatives. OMS is committed to advancing health equity efforts to improve access to care and health outcomes for all low-income Mainers. OMS provides benefit coverage and supports the services that operate in alignment with Department goals, federal mandates and State policy. OMS also provides oversight necessary to ensure accountability and efficient and effective administration.  

The Complex Case Unit (CCU) within the Office of MaineCare Services works with MaineCare members and other Maine residents to address complex healthcare, finance, and placement challenges. The CCU brings together providers, community partners, and state agencies to coordinate care, address barriers, and develop solutions when usual resources and services have not resolved an individual's needs. The Complex Case Unit leads efforts to resolve members' complex issues by facilitating team meetings and providing a structured path towards resolution.

Application Information:

For questions about this position, please contact Michele Lane at (207) 624-4078.

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 – 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 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.
• Voluntary Deferred Compensation – Save additional pre-tax funds for retirement in a MaineSaves 457(b) account through payroll deductions.

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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