Medicaid Director and Assistant Secretary for MassHealth Operations

Job 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
• Advance organizational effectiveness by promoting data-informed decision-making, performance measurement, and continuous process improvement
• Foster a collaborative, high-performing staff culture that supports problem-solving, clear communication, and consistent decision-making across complex program areas

• A minimum of ten (10) years of significant leadership experience leading large, complex healthcare or public sector organizations with responsibility for strategy, operations, and financial oversight
• Deep knowledge of Medicaid programs, including Title XIX and Title XXI, with experience in policy development, waiver design, and federal compliance
• Strong understanding of healthcare economics, reimbursement methodologies, and rate-setting strategies across diverse provider types
• Proven ability to lead cross-functional teams and drive alignment across multiple agencies or business units in a highly matrixed environment
• Experience negotiating with federal agencies, healthcare providers, managed care organizations, and other key stakeholders
• Demonstrated track record of leading large-scale organizational change, including process improvement, system transformation, and change management initiatives
• Capacity to use data and analytics to inform policy decisions, measure program performance, and drive continuous improvement
• Experience managing large budgets and ensuring fiscal accountability in a complex funding environment
• Ability to achieve the Office's mission and goals through effective planning and management of programs, resources and staff
• Strong executive communication skills, with the ability to influence senior leadership, policymakers, and external partners
• Proficient with Microsoft Office applications including Excel, Word, Outlook, PowerPoint, and Teams