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 Mass Health 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://(Use the "Apply for this Job" box below)..

The EOHHS IT team, supporting the Mass Health 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.

Mass Health 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. Mass Health 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, 9:00 AM to 5:00 PM 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, Mass Health or vendor locations within the Commonwealth of MA in support of their work.

• Accountable for Stability and Performance of MMIS/MES products
• Maintain accountability for the performance, reliability, and compliance of legacy MMIS
• Oversee applications/products for claims adjudication, provider management, member processing, and financial operations
• Ensure continuity of operations excellence, disaster recovery, and system integrity including oversee production support schedules, operational readiness activities, and on–call support processes.
• Ensure operational excellence in management, communication, partnership, and teamwork.
• Develop and strengthen internal understanding of MMIS architecture, business processes, integrations, and operational dependencies to reduce reliance on vendor-held knowledge.
• Develop and execute plans to reduce technical debt, remediate security vulnerabilities, improve maintainability, and increase platform resiliency.
• Oversee planning, forecasting, and reporting of development activities, resource needs, delivery timelines, and modernization initiatives.
• Establish and monitor operational, modernization, and service delivery metrics to drive accountability, performance improvements, and executive decision‑making.
• Provide executive leadership during critical incidents, major outages, and operational escalations, ensuring effective communication, root‑cause analysis, and remediation planning.
• Directly supervise managers and staff…