Chief Medical Officer

Baystate Health • Springfield, MA

3d

About The Position

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.

Requirements

• 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
• 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
• Doctor of Medicine

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

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Education Level: Ph.D. or professional degree
• Number of Employees: 5,001-10,000 employees