If you’ve ever wanted to do mission-driven product development somewhere that’s investing in doing it right, now’s the time to pay attention to what’s happening at Hawaii’s Med-QUEST division.
Med-QUEST, Hawaii’s Medicaid program, provides healthcare coverage to just under 400,000 in Hawaii’s diverse community including working families, kids, older adults, and people with disabilities. And right now, Med-QUEST leadership is breaking out of the standard operating models that we’ve all become accustomed to at state agencies: They are building a dedicated Customer Experience (CX) Office, staffed with senior product managers, designers, and software engineers, reporting directly to agency leadership with a mandate to fix real problems using a test-and-learn approach.
This isn’t a committee. It isn’t a one-off contract. It’s a real team, with real authority, working on a real and urgent problem.
Why now?
Hawaii, like every other state in the U.S., is facing a hard deadline. New federal legislation (H.R.1) requires states to implement Medicaid work requirements by January 1, 2027. It includes increased eligibility checks from yearly to every six months for expansion populations and new verification rules. This creates a massive administrative load on top of a system that’s already strained. Governor Green’s FY2027 budget shows a commitment to ensuring healthcare access with real dollars, and the CX Office is part of how that commitment gets operationalized.
What the CX Office is set up to do
The conventional government response to problems like these is to set up a short term project or add staff to manage the increased administrative burden. Med-QUEST is attempting something different. They are building institutional capacity to test what’s actually failing, learn from real members and community organizations, and improve continuously.
Cross functional by design
The initial team brings together a Customer Experience Officer, a Product Manager, Human-Centered Designers, and a Software Engineer (all senior level roles) with one shared definition of success focused on measurable outcomes for beneficiaries.
Reporting into leadership
Learning becomes useful when it can change decisions, which requires access to the people overseeing the entirety of the systems. The CX Office reports directly to the Med-QUEST Administrator. It is not buried several layers down. That means the people doing the research and building prototypes have a direct line to the decision-makers.
Success is about outcomes for users
The team’s success is measured by how it’s supporting eligible residents: improving renewal success rates, reducing drop-off rates in the application process, and reducing procedural terminations (when people lose coverage because of paperwork reasons for instance instead of because they are actually ineligible.) The question won’t be “did we ship this feature”, but instead using test and learn in practice to ask “did member outcomes actually improve, and what do we do differently if they didn’t.”
Starting small to test and learn
Rather than trying to fix everything at once, the first team is intentionally scoped to a single, beneficiary-facing outcome core to the agency’s mission. This team will deliberately apply the test-and-learn principle that anything working at scale started small and proved the approach, built credibility, and then grew.
Designed to work collaboratively
One of the most common failure modes in government innovation is a team that works in a vacuum ignoring the regulators overseeing the system, environmental constraints, and the deep expertise that civil service staff bring to the table, resulting in solutions that don’t last. The CX Office is explicitly designed to embed with Hawaii’s existing partners both inside and outside Hawaii state government, leading to sustainable, resilient operating models.
Why this might be the role for you
If you are a product manager, designer, or engineer that wants to help make government services just work, this is a chance to do something about it. It is rare to find government organizations that have the operating model and/or culture to support a test and learn approach. Med-QUEST is building both.
At the Tech Talent Project we are genuinely excited about collaborating with Med-QUEST on this journey from launch through evaluation. We’ll keep you posted as positions formally open and, if you want to learn more, reach out to our team.