Chief Medical Officer

Chief Medical Officer (CMO)

Baystate Health / Health New England

Western Massachusetts

About the Role

Reporting to Chief Physician Executive the Chief Medical Officer (CMO) of Health New England is a key member of the Executive Leadership Team. The CMO of Health New England serves as the lead physician executive driving clinical strategies across commercial Medicaid ACO and Medicare Advantage lines of business while strengthening the integrated payer-provider partnership within Baystate Health.

This role provides strategic leadership and oversight across Population Health Pharmacy Quality & Accreditation Wellness Programs and Medical Services while ensuring alignment between clinical excellence affordability and member outcomes.

Key Responsibilities

Strategic & Executive Leadership

• Provide clinical and quality vision aligned with organizational strategy regulatory requirements and business objectives
• Serve as a trusted executive leader with strong presence across stakeholders including health plan health system brokers physician networks and employer groups
• Build trust and influence across a broad integrated stakeholder environment

Population Health & Value-Based Care

• Lead population health and value-based care strategy including risk-based contracting and initiatives that improve quality while reducing total cost of care
• Drive programs that improve affordability quality outcomes and member experience across all lines of business
• Translate clinical analytics risk scores and quality measures into actionable strategies

Clinical & Medical Management

• Provide oversight of utilization management care management and evidence-based medical policies
• Ensure appropriate resource utilization while reducing unnecessary variation in care
• Oversee medical necessity determinations and clinical appeals processes

Quality Compliance & Regulatory Oversight

• Lead quality and accreditation programs including CMS Stars HEDIS NCQA and CAHPS
• Ensure compliance with federal and state regulatory requirements including MassHealth guidelines
• Promote patient safety clinical excellence and continuous quality improvement

Physician Leadership & Alignment

• Engage and align physicians and provider networks to adopt clinical protocols technology and value-based care initiatives
• Strengthen provider partnerships across Baystate Health and the broader Western Massachusetts market

Analytics & Innovation

• Leverage clinical informatics business intelligence and analytics to drive performance and decision-making
• Partner with internal teams to support payment integrity contracting and innovation strategies

Business & Financial Acumen

• Balance clinical priorities with financial performance including revenue cycle cost of care and growth strategies
• Contribute to strategic planning sales efforts and competitive positioning

Qualifications

• MD or DO required; Board Certification preferred
• Significant executive leadership experience in a health plan health system or integrated delivery network
• Extensive experience in:
  • Risk adjustment ACO models and STAR rating improvement strategies
  • Population health management and value-based care
  • Medical management and provider partnership roles
• Demonstrated ability to:
  • Interpret clinical and financial data and translate into strategy
  • Influence and lead across complex matrixed organizations
  • Build credibility with physicians executives and external stakeholders

Core Competencies

• Executive presence and stakeholder influence
• Population health and clinical analytics leadership
• Utilization and clinical management expertise
• Quality and regulatory knowledge (CMS Stars HEDIS NCQA)
• Physician engagement and alignment
• Data-driven decision making
• Strategic and financial business acumen

Why Baystate Health

At Baystate Health we are committed to improving the health of our communities through quality compassion and innovation. As a leading integrated health system this role offers a unique opportunity to shape care across both the provider and payer landscape.

Join an organization where clinical leadership drives meaningful impactadvancing health outcomes improving equity and transforming care delivery across Western Massachusetts.

Education:

Certifications:

Compensation

Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidates relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.

Minimum - Maximum

$ 377800 - $ 551300

Equal Employment Opportunity Employer