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 promotes the health, resilience, and independence of nearly one in three residents of the Commonwealth we serve. Our public health programs touch every community in the Commonwealth. For more information, visit EOHHS.

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. This role leads the Commonwealth’s core Medicaid technology portfolio, including MMIS, while advancing interoperability, operational excellence, and modernization aligned with CMS Medicaid Enterprise System (MES) guidance.

Responsibilities

• Accountable for the stability, performance, security, compliance, and operational integrity of MMIS and MES platforms.
• Oversee Medicaid technology operations, including claims adjudication, provider management, member processing, financial operations, and enterprise integrations.
• Ensure operational excellence through production support, incident management, disaster recovery, business continuity, and service reliability practices.
• Lead MMIS modernization and CMS-aligned MES transformation initiatives, including technical debt reduction, platform resiliency, interoperability, and lifecycle management.
• Develop and maintain the MMIS/MES technology roadmap, aligning modernization priorities with business objectives, regulatory requirements, and enterprise strategy.
• Establish governance, metrics, and reporting to drive accountability, service delivery performance, operational improvements, and executive decision-making.
• Lead cross-functional collaboration across MMIS, MES, Eligibility & Enrollment, Security, Operations, and enterprise teams to improve delivery, transparency, and accountability.
• Provide executive leadership during critical incidents, major outages, and operational escalations, ensuring effective communication, root-cause analysis, and remediation planning.
• Directly lead managers, staff, contractors, and vendors, including workforce development, performance management, contract oversight, and succession planning.
• Partner with business leaders and product owners to align technology investments, priorities, and delivery outcomes with MassHealth objectives.
• Manage vendor relationships, budgets, financial planning, and technology initiatives supporting MMIS operations, MES transformation, CMS certification, and federal funding opportunities.
• Partner with Enterprise Architecture and shared services teams to establish technology standards, governance frameworks, integration strategies, and enterprise-wide alignment across the Medicaid ecosystem.

Required Qualifications

• 5–10 years of senior-level leadership experience overseeing technology, operations, enterprise applications, or large-scale service delivery organizations.
• Experience leading large-scale, mission-critical enterprise applications that support complex business operations, regulatory requirements, and high-volume transaction processing (e.g., Medicaid enterprise systems (MMIS/MES), healthcare payer platforms, financial systems, or other large public-sector technology environments).
• Experience overseeing complex application ecosystems with numerous integrations, interfaces, vendors, and external dependencies.
• Experience managing operationally critical systems requiring high availability, regulatory compliance, and continuous delivery of policy-driven changes.
• Demonstrated success improving delivery execution, collaboration, and accountability across cross-functional teams in complex organizational environments.
• Experience leading organizational and cultural change initiatives, particularly in environments with established silos and competing priorities.
• Strong stakeholder management skills, with the ability to effectively navigate competing priorities and drive consensus among diverse stakeholder groups.
• Experience managing vendors, strategic partnerships, and large-scale technology contracts.
• Proven ability to influence leaders and teams outside of direct reporting relationships to achieve shared organizational outcomes.
• Experience implementing operational improvements that result in measurable gains in delivery performance, collaboration, efficiency, or service reliability.
• Excellent written, verbal, and executive-level communication skills.

Preferred Qualifications

• Understanding of enterprise application architecture, system integration patterns, and large-scale technology ecosystems.
• Experience implementing organizational, operational, or delivery improvements in complex environments with multiple stakeholders and competing priorities.
• Familiarity with Medicaid Enterprise Systems (MMIS/MES), including eligibility and enrollment, provider management, claims processing, and financial operations; knowledge of CMS MES guidance and the MITA framework is preferred.
• Experience managing complex technology environments while maintaining a strong focus on customer service, operational excellence, and regulatory compliance.
• Proven success improving delivery execution, cross-team coordination, transparency, and accountability across large or highly matrixed organizations.
• Experience establishing governance, intake, prioritization, and delivery management processes that improve execution while minimizing unnecessary bureaucracy.
• Demonstrated ability to lead teams through organizational change while maintaining operational stability and meeting delivery commitments.
• Experience implementing Agile, iterative, or hybrid delivery practices that improve coordination, transparency, and execution in operational environments.
• Experience supporting or leading transitions from system-centric to product- or service-oriented operating models.
• Experience working within or alongside shared services organizations.
• Demonstrated ability to simplify processes, reduce organizational complexity, and improve operational effectiveness.
• Experience balancing long-term transformation initiatives with ongoing operational, policy, and regulatory demands.
• Proven success identifying and mitigating workflow bottlenecks, delivery risks, and organizational friction points.
• Experience developing and using operational metrics, dashboards, and KPIs to improve visibility, accountability, and decision-making.
• Experience working in highly regulated healthcare, human services, or public-sector environments.