Director, Medicaid Platforms & Products - Medicaid Enterprise Systems (MES)

About the Organization:

The Executive Office of Health and Human Services (EOHHS) is comprised of 11 agencies and the MassHealth program.  EOHHS seeks to promote the health, resilience, and independence of the nearly one in three residents of the Commonwealth we serve. Our public health programs touch every community in the Commonwealth.  To know more about EOHHS please visit  https://www.mass.gov/orgs/executive-office-of-health-and-human-services.  

About the Role:

The EOHHS IT team, supporting the MassHealth program within the Executive Office of Health and Human Services (EHS), is seeking a Director of Medicaid Platforms & Products to lead the Commonwealth’s core Medicaid technology portfolio, including MMIS, while advancing interoperability, operational excellence, and modernization aligned with CMS Medicaid Enterprise System (MES) guidance.

MassHealth Agency responsible for the Medicaid and CHIP programs for Massachusetts, providing access to healthcare services to approximately 2 million low-income and disabled residents of the Commonwealth. MassHealth is responsible for a ~$22 billion annual budget comprised of insurance premiums, payments for healthcare services, payments for pharmaceutical therapies, administrative expenses, and more.

The Director is responsible for the overall operation of MMIS, including production support, system performance, strategic planning, enhancement delivery, release management, and operational reliability. This role will serve as a key partner to the ACIO for Medicaid Enterprise Systems, helping deliver ongoing Medicaid priorities while addressing challenges related to legacy system dependencies, technical debt, interoperability, technology governance, operational visibility, and alignment with enterprise standards.

The Director will oversee MES modules within the MMIS environment, including Claims Processing, Encounter Processing System (EPS) & Managed Care System, Financial Management, Member Management, Program Integrity, and Provider Management, while supporting interoperability and integration with enterprise systems and services. The role is responsible for coordinating business, vendor, and IT resources to support operational success and the Commonwealth’s Medicaid technology transformation roadmap.

The primary work location for this role will be at 1 Enterprise Drive, Quincy, Massachusetts 02171. The work schedule for this position is Monday thru Friday, 9:00AM to 5:00PM EST.  This position would be expected to follow a hybrid model of reporting to work that combines in-office workdays and work from home days as needed.  The Director is expected to occasionally travel to EOHHS, MassHealth or vendor locations within the Commonwealth of MA in support of their work.

This role combines:

• Operational accountability for MMIS and MES platforms, including claims, provider, member, financial, and program integrity functions
• Technology portfolio and delivery leadership
• Cross-team delivery leadership and organizational change
• Vendor, compliance, and operational oversight

The ideal candidate will be:

• a technically proficient leader with the ability to understand complex systems, articulate system interactions and dependencies, and effectively partner with business and technology stakeholders across the enterprise
• a strong operator leader who can manage large-