Medicaid Management Information Systems (MMIS) Operations Manager

About the job

If you are a current State of Maine employee, please submit your application through the internal application process using the Find Jobs report in PRISM. Seasonal employees who do not have PRISM access should apply through the State’s career page and indicate on the application that they have previously worked for the State.

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Department of Health and Human Services (DHHS)

Senior Business Systems Manager

Opening Date: November 13, 2026

Closing Date: November 30, 2026

Job Class Code: 0048

Grade: 30 (Supervisory)

Salary: $72,196.80 - $102,086.40 per year

Position Number: 02000-2106

Location: Augusta

This position reports to the MMIS Associate Director. The position is located in Augusta, Maine and allows for partial telework with management approval.

Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

Core Responsibilities:

As the Medicaid Management Information System (MMIS) Operations Manager, you will be responsible for oversight of day-to-day the Maine Integrated Health Management Solution (MIHMS) operations activities undertaken by the Office of MaineCare Services (OMS) and by the Department’s contracted fiscal agent, who is responsible for maintaining and operating MIHMS. You will facilitate regular and ad-hoc communication and collaboration with other State policy, program, operations, analytics, and technical teams and with the fiscal agent to build consensus around needed changes, implementation approaches, and schedules. You will oversee the cyclical review and approval of system and process documentation. You will contribute to workplan development, align the team to broader business needs and priorities, and evaluate and update processes for efficiency and effectiveness. You will participate in internal and external workgroups that focus on strategic planning, operational improvements, and information sharing about best practices, directly and indirectly related to MIHMS.

This position will oversee two functional areas:

1.        The Change Management team is responsible for facilitating all changes to MIHMS. The team identifies, solicits, researches, defines, documents, and tracks MIHMS changes stemming from internal and external business, regulatory, compliance, and financial needs. This team works collaboratively across OMS business areas and with the fiscal agent.

2.        The User Acceptance Testing team performs testing to ensure that final MIHMS system changes will perform as designed when they are moved to the production environment. This team works collaboratively across OMS business areas and with the fiscal agent.

Work is performed under minimal supervision.

Regular duties include:

•        Supervising eight state and contracted staff on the Change Management and User Acceptance Testing teams to ensure that work is appropriately assigned, prioritized, scheduled, and executed according to established workplans and deadlines;

•        Facilitating and/or attending meetings with other functional teams to understand the need for upcoming MIHMS changes and associated milestones, deadlines, and priorities, as well as the impact of MIHMS changes on other teams and functions;

•        Working closely with team members, the fiscal agent, and the MMIS Associate Director to ensure that MIHMS changes are designed, developed, tested, and implemented in accordance with established policies, procedures, workplans, and priorities;

•        Leading high priority or urgent projects and activities when needed;

•        Reviewing and approving work and contract-related deliverables from the fiscal agent to ensure they are complete, accurate, within budget and that they meet business requirements;

•        Leading the processes to escalate, triage, and resolve MIHMS technical issues affecting Department staff;

•        Providing recommendations and feedback to OMS leadership on operational issues, prioritization of tasks, schedule challenges between competing priorities, and approaches to address system enhancements and updates;

•        Facilitating responses to relevant state and federal audit requests and reviewing the fiscal agent’s audit reports escalating to the MMIS Associate Director as needed;

•        Working with the fiscal agent on planning for, executing, and improving MIHMS disaster recovery exercises;

•        Reporting on the status of MIHMS operations activities as needed and leading federal reporting on MMIS operational metrics; and

•        Providing direction to team members on issues, questions, and decisions and escalating to the MMIS Associate Director as needed.

Minimum Qualifications:

A nine (9) year combination of education, training, and/or professional experience in project management, systems analysis, business analysis, or related field demonstrating knowledge of project management concepts, systems improvement, and the ability to develop and implement business plans.  Experience must include at least two (2) years of information technology project management.

Preferred experience includes:

•        Experience with and knowledge of the Medicaid program and/or other health and human services programs serving low-income populations

•        Lived experience with Medicaid and/or other health-related social needs common to individuals and families receiving Medicaid coverage

The background of well-qualified candidates will demonstrate the following competencies. Please address these competencies in your cover letter:

1.        Experience managing projects through the Software Development Life Cycle, including knowledge of change management processes, practices, and tools, and the ability to read, understand, and interpret technical documentation;

2.        Significant experience building trust-based partnerships across and facilitating communications with and among internal and external stakeholders, including those who have varying levels of technical knowledge;

3.        Strong leadership skills and a proven ability to direct and oversee the work of staff while building relationships, motivating others, and encouraging professional growth and development;

4.        Proven record of success in project management, preferably within a large technology project, with a focus on taking initiative, establishing quality standards, improving the efficiency and effectiveness of workflows, tracking results, and evaluating outcomes;

5.        Already possesses or the ability to develop a working knowledge of data systems and applications and to comprehend, analyze, and manage complex data.

Thinking about applying?

Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you’re currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your experience and passion set you apart.

Agency information:

The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience, and opportunity for Maine people. The Department provides health and social services to approximately a third of the State's population, including children, families, older Mainers, and individuals with disabilities, mental illness, and substance use disorders. The Department also promotes public health, operates two state psychiatric hospitals, and provides oversight to health care providers.

The Office of MaineCare Services (OMS) within DHHS administers the state’s Medicaid program, which provides free or low-cost health insurance coverage for low-income Mainers so they can access the health care services they need to work, care for family, go to school, and participate in the community. OMS works collaboratively with other State agencies, the Legislature, the Office of the Governor, MaineCare members, health care providers, and other health care purchasers on statewide healthcare improvement initiatives. OMS is committed to advancing health equity efforts to improve access to care and positive health outcomes for all low-income Mainers. OMS provides benefit coverage and support services in alignment with Department goals, federal requirements, and State statutes. OMS also provides oversight necessary to ensure accountability and efficient and effective administration of the state’s Medicaid program.

The Department’s Medicaid Management Information System (MMIS) is a large technology platform that forms the backbone of MaineCare operations and sits within Maine’s broader Medicaid Enterprise System (MES). At its core, the MMIS processes and pays primarily fee-for-service claims from healthcare providers for services rendered to MaineCare members. In Maine, the MMIS is known as the Maine Integrated Health Management Solution (MIHMS). Each week, through MIHMS, OMS processes almost 350,000 medical, dental, and pharmacy claims and pays healthcare providers more than $100 million for the delivery of services. MIHMS includes multiple functional modules and is operated by a fiscal agent vendor partner. MIHMS is the State’s largest technology contract.

More information about MIHMS: Healthcare providers use MIHMS to enroll with MaineCare, check member eligibility, submit prior authorization requests, and submit healthcare claims. The Department and fiscal agent use MIHMS to manage eligibility data, reimburse providers for claims, analyze data, and support staff’s daily workflows. MIHMS must be compliant with federal and state regulations while supporting the Department’s programmatic goals. The work of nearly all teams in OMS – as well as multiple teams outside OMS - interface with the MIHMS platform; external users also access MIHMS via an online portal.

Application Information:

For questions about this position, please contact Peter Lewis at 207-215-1424.

Please submit all documents or files in a PDF or Word format.

To request a paper application, please contact Mandy.Hernandez@Maine.gov

Benefits of working for the State of Maine:

No matter where you work across Maine state government, you find employees who embody our state motto—"Dirigo" or "I lead"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total compensation package, including:

• Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave. When you or immediate members of your family are ill, utilize 12 days of sick leave per year.
• Health Insurance Coverage – The State of Maine pays 85%-95% of employee-only premiums ($12,213.60 - $13,650.48 annual value), depending on salary. Use this chart to find the premium costs ****for you and your family, including the percentage of dependent coverage paid by the State.
• Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%. Visit the Office of Employee Health and Wellness for more information about program requirements.
• Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($365.28 annual value).
• Retirement Plan – The State contributes the equivalent of 14.06% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS), on behalf of the employee.
• Gym Membership Reimbursement – Improve overall health with regular exercise and receive up to $40 per month to offset this expense.
• Health and Dependent Care Flexible Spending Accounts – Set aside money pre-tax to help pay for out-of-pocket health care expenses and/or daycare expenses.
• Public Service Student Loan Forgiveness – The State of Maine is a qualified employer for this federal program. For more information, visit the Federal Student Aid office.
• Living Resources Program – Navigate challenging work and life situations with our employee assistance program.
• Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing and adoptive parents—receive six weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act.
• Voluntary Deferred Compensation – Save additional pre-tax funds for retirement in a MaineSaves 457(b) account through payroll deductions.

State employees are eligible for an extensive and highly competitive benefits package, covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.

Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for anything less than full-time.

*There's a job and then there's purposeful, transformative work. Our aim is to create a workplace where you can learn, grow, and continuously refine your skills. Applicants demonstrate job requirements in differing ways, and we appreciate that many skills and backgrounds can make people successful in this role. *

*As an Equal Opportunity employer, Maine State Government embraces a culture of respect and awareness. We are committed to creating a strong sense of belonging for all team members, and our process ensures an inclusive environment to applicants of all backgrounds including diverse race, color, sex, sexual orientation or gender identity, physical or mental disability, religion, age, ancestry, national origin, familial status or genetics. *

If you’re looking for a great next step, and want to feel good about what you do, we’d love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.

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If you are unable to complete the online application, please contact the Human Resources representative listed on the job opening you are interested in applying for. They will work with you for an alternative method of submitting.