Medicaid Director and Assistant Secretary for MassHealth Operations
Commonwealth of MassachusettsAbout the role
Description
The Medicaid Director and Assistant Secretary for MassHealth Operations serves as a senior executive leader responsible for overseeing the strategy, policy, and operations of MassHealth, the Commonwealth’s Medicaid and Children’s Health Insurance Program (CHIP), which provides coverage to more than two million Massachusetts residents and manages an annual budget exceeding $23 billion. Operating within the Executive Office of Health and Human Services (EOHHS) and reporting to the Secretary of EOHHS, this role is central to ensuring that MassHealth delivers high-quality, cost-effective care while maintaining full compliance with federal requirements. You will lead the administration of the State Plan, waiver programs, and major initiatives such as the Money Follows the Person (MFP) Demonstration, while providing oversight across policy development, clinical affairs, finance, eligibility and provider operations, data and analytics, and IT. In addition, you will guide the MassHealth Executive Team, advise executive leadership, and represent the Commonwealth in high-level engagements with federal partners, providers, managed care organizations, and key stakeholders.
This role operates at the intersection of policy, operations, and interagency coordination, requiring a leader who can navigate complex regulations, align priorities across multiple EOHHS agencies, and strengthen communication and collaboration in a highly decentralized environment. You will shape Medicaid policy, reimbursement strategies, program evaluation, and data-driven decision-making while addressing long-standing challenges related to coordination, funding alignment, and program integration across health and human services. Success in this role requires deep expertise in Medicaid and health care economics, strong executive leadership experience, and the ability to manage competing priorities under significant time pressure. You will play an essential role in advancing organizational effectiveness, driving system-wide improvements, and ensuring that MassHealth continues to meet the needs of the Commonwealth’s most marginalized populations.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
Provide executive oversight of MassHealth operations to ensure program goals are achieved, budgets are maintained, and all activities comply with federal and state requirements
Lead the development, implementation, and continuous improvement of Medicaid policy across all major program areas, including clinical, behavioral health, pharmacy, long-term services and supports, and provider programs
Direct and coordinate the MassHealth Executive Team to ensure alignment across eligibility, provider operations, finance, program integrity, strategy, data and analytics, and information technology functions
Oversee the design and execution of Medicaid State Plan initiatives, waiver programs, and demonstration projects, including the MFP Demonstration initiative
Establish and maintain effective collaboration with legal counsel, EOHHS leadership, and cross-agency partners to support compliant, coordinated program operations
Represent MassHealth and EOHHS in external engagements, including negotiations with federal partners such as the Centers for Medicare and Medicaid Services and discussions with providers, managed care organizations, and advocacy groups
Lead provider reimbursement strategy and rate-setting priorities, ensuring alignment with program goals, fiscal sustainability, and market competitiveness
Drive cross-agency policy alignment and operational coordination to strengthen integration of Medicaid-funded services across EOHHS agencies
Advise the EOHHS Secretary and contribute to executive-level decision-making as a member of the leadership team
Strengthen vendor management and performance oversight to ensure high-quality service delivery and accountability across contracted partners
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