Advancing Medicaid systems to improve service delivery

With over three decades in public program technology, Paula Wales, managing director of Medicaid Enterprise Services, has become a guiding force in Medicaid modernization at Maximus. She has extensive experience in partnering with state governments to design and implement large-scale health and human services technology systems, helping shape long-term strategies and ensure successful program execution.

Known for her pragmatic, collaborative approach, Paula has been instrumental in transforming complex Medicaid systems into modular, adaptable structures that streamline processes for providers and ease program management for state clients.

Her long career in supporting government programs reflects an enduring commitment to improving access to and delivery of essential healthcare services for millions.

Early in my career, I worked as a software developer on child support systems that made a real difference for families and state agencies. One of my most memorable projects was building a system in Colorado to standardize how child support payments were managed across counties. Seeing how technology improved the lives of families and streamlined work for state employees was a turning point for me — it made me realize this was the kind of work I wanted to do. I also worked on similar projects in Wyoming, Oklahoma, Iowa, and New Mexico, helping states modernize their systems and make them more efficient. Those experiences opened my eyes to the positive impact government systems can have on people’s lives.

I later moved into the Medicaid space, helping states to implement our provider enrollment and screening system.

I’m collaborative to my core. I love bringing people together to brainstorm and get creative about solutions. It’s energizing, and it gives everyone a chance to show off their strengths. I believe that by combining everyone’s different perspectives, we can do great work. When working with our government clients, I focus on listening first to fully understand their specific needs then adapt solutions to fit. I’m also driven by a strong sense of curiosity and tenacity — I enjoy taking on new challenges, learning new things, and finding fresh ways to make an impact.

For many states, modularity is both freeing and challenging. Managing multiple procurements and vendors is complex and can be daunting. States need flexible, long-term solutions that don’t require frequent rethinking or re-bidding. Modularity opens new opportunities for vendors, but for some states, it can be an intimidating shift. Maximus is well-equipped with deep knowledge and experience to help states implement their modernization projects with confidence and ease. 

We developed a provider enrollment module aimed at reducing what we call “provider abrasion” — making it easier for providers to enroll without encountering frustrating bottlenecks. We also developed a centralized credentialing system that simplifies and streamlines the process by eliminating the need for providers to engage with individual health plans for credentials. By making processes seamless through user-friendly systems, we encourage more providers to participate, which ultimately expands access to care for Medicaid recipients.

Be a learner! Dive deep into the programs you’re involved with and take time to learn from your colleagues. My career has been shaped by constantly learning and adapting, and at Maximus, there’s so much talent and expertise to tap into. The more you understand, the more value you can bring to the people you serve.