Senior Medical Director, Population Health Strategy

Ready to help us transform healthcare? Bring your true colors to blue.
The Role
Reporting to the Vice President, Clinical Programs and Strategy, this individual will be a market and provider-facing leader responsible for engaging accounts and provider groups in achieving BCBSMA’s goals of affordability, equity, quality and experience. He she will lead teams, develop and implement strategy, and serve as both a clinical expert and an operational leader across a range of high-visibility efforts.
Major Responsibilities
Leads Client Population Health Team, responsible for
Engaging accounts (purchasers) in partnership with Sales and Marketing colleagues, including regular account presentations to highlight population health opportunities and interventions, BCBSMA capabilities and expertise, and ad hoc clinical topics of interest.
Providing clinical support for integrated corporate initiatives, employer buy-up programs, account cost trend issues and customized solutions to meet account needs. This includes evaluation of clinical impact and evidence, recommendations about strategy, and education to internal non-clinical staff and external stakeholders.
Clinical oversight of High Cost Case review process, in partnership with colleagues from Medical Policy, Pharmacy leadership, Sales, Actuarial, and Performance Management.
Health and Medical Management (HMM) related RFP questions
HMM Performance Guarantees
Account-facing HMM collateral development
Sales Trainings
Building vision for the evolution of these engagement efforts, defining multi-year strategy and road-map to achieve desired objectives
Working collaboratively across key business partners to implement vision in the market and meet/exceed objectives
Development and coaching of Client Population Health Team staff
Lead, mentor, and grow a world-class team, providing strategy, execution, coaching, mentoring, and decision-making leadership throughout the organization, with a growth mindset
Performance management and HR tasks
Team organization and supervision
Drive team accountability on progress and fulfillment of goals and objectives, providing feedback and coaching, and formally reviewing and recognizing performance.
Coordination with other teams across HMM and other areas of BCBSMA
In collaboration with colleagues from Performance Measurement and Improvement (PMI) and Network and Provider Services, leads provider engagement for quality and population health
Clinical lead for Alternative Quality Contract (AQC) and Small Group provider group engagement
Define and implement strategy for achieving quality and population health performance goals
Engage provider group leadership in efforts to improve disparities in quality outcomes by race and ethnicity
Champion Diversity, Equity, and Inclusion as a core focus with both accounts and providers
Partner with PMI colleagues in further developing and implementing equity performance strategy for AQC
Serve as clinical expert and consultant to advise Sales and Marketing, PMI, Network and Provider Services, Legal, or other areas of the organization as needed
Maintain current knowledge of developments in published medical literature which should inform BCBSMA strategy and operation
Partner closely with Product, Network and Provider Services, PMI, Customer Experience, Enterprise Technology, Finance/Actuarial and Sales leadership to ensure the voice of the customer influences our product development
Serve on key HMM and other BCBSMA and BCBS Association Committees, as needed
Participates in projects as assigned by the Vice President, Clinical Programs and Strategy and in collaboration with the BCBSMA senior management team
Other duties as assigned
Qualifications, Education, and Experience
MD or equivalent degree
MBA, MPH or similar strongly desired
Minimum 5 years in post-residency clinical practice
Minimum of 5 years in leadership role within a provider organization, payer, or regulatory agency
Demonstrated ability to lead cross-functional teams
Demonstrated ability to engage physicians/clinicians in process/quality improvement, population health, and innovation
Excellent communication (written/verbal), analytical, problem solving, change management and conflict resolution skills
Goal oriented with an ability to deliver results against established team and organizational goals
Proven ability to excel in heavily matrixed environment
Compensation
The compensation package will reflect the senior leadership role of an innovative and nationally recognized health plan and commensurate with the role and responsibilities of the position.
Minimum Education Requirements:
High school degree or equivalent required unless otherwise noted above
Location Boston Time Type Full time
Salary Range: $264,060.00 - $322,740.00
The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.
This job is also eligible for variable pay.
We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
WHY Blue Cross Blue Shield of MA?
We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.
As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue.
At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. We provide a flexible hybrid work model in which roles are designated as resident (on site 4-5 days/week), mobile (on site 1-3 days/week), or eworker (on site 0-3 days/month).