Medicaid Director and Assistant Secretary for MassHealth Operations

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

Preferred Qualifications :

• 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

About MassHealth / Office of Medicaid:

MassHealth is one of the largest and most impactful public programs in Massachusetts, providing comprehensive health coverage to more than two million residents, including children, families, seniors, and individuals with disabilities. The program plays a central role in advancing health equity and ensuring access to essential services such as primary and specialty care, behavioral health, pharmacy, and long-term services and supports. With an annual budget exceeding $23 billion, MassHealth operates as a critical federal and state partnership that not only funds health care coverage but also supports a broad range of health and human services across the Commonwealth.

The Office of Medicaid, established in accordance with federal requirements, serves as the single state Medicaid agency within the Executive Office of Health and Human Services (EOHHS) and is responsible for the overall administration, coordination, and strategic direction of the MassHealth program. The Office of Medicaid ensures alignment across multiple agencies, oversees policy development and program implementation, and manages key areas such as reimbursement, waiver programs, clinical affairs, and operational performance. The office plays an essential role in integrating Medicaid funding and services across the health and human services system, strengthening interagency collaboration, and ensuring that MassHealth delivers high-quality, cost-effective care to residents across the Commonwealth.

Learn more: MassHealth

Pre-Hire Process:

A tax & background check will be completed on the recommended candidate as required by the regulations set forth by the Human Resources Division prior to the candidate being hired.

Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines.

Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.

ADA Reasonable Accommodation:

If you require a reasonable accommodation with the application/interview process, please contact us at: EOHHS Candidate ADA Requests

For questions regarding this requisition, please contact the Executive Office of Health and Human Services Human Resources at 1-800-510-4122 Ext. #4.

Qualifications

MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least (A) eight (8) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least six (6) years must have been in a managerial capacity.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

Want the specifics? Explore our Employee Benefits and Rewards!

An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.

Official Title : Administrator XII

Primary Location : United States-Massachusetts-Boston-1 Ashburton Place

Job : Accounting and Finance

Agency : Exec Office Of Health and Human Services

Schedule : Full-time

Shift : Day

Job Posting : Apr 8, 2026, 4:18:04 PM

Number of Openings : 1

Salary : 146,119.39 - 226,740.67 Yearly

If you have Diversity, Affirmative Action or Equal Employment Opportunity questions or need a Reasonable Accommodation, please contact Diversity Officer / ADA Coordinator : Kendy Derival / [email protected] - 6173488456

Bargaining Unit : M99-Managers (EXE)

Confidential : No

Potentially Eligible for a Hybrid Work Schedule : Yes