Chief Population Health Officer/Vice President, Population Health & Chief Medical Officer, MGB Health Plan at Mass General Brigham in Somerville, Massachusetts

Job Description:

The Chief Population Health Officer (CPHO), Mass General Brigham (MGB) & Chief Medical Officer, MGB Health Plan develops and executes the Population Health Management Organization (PHSO) and value-based payment (VBP) strategy for Mass General Brigham. Reporting directly to the Chief Integration Officer in the CPHO role and directly to the President of MGB Health plan (MGBHP) in the CMO role, this role demands both visionary leadership and operational execution to support excellence in population health outcomes across MGB's integrated delivery and financing system, while also driving highly reliable results in MGB's value-based payment programs and managing medical loss ratio (MLR) through clinical programs at MGBHP. As CPHO, the leader is responsible for expanding and evolving the established foundation of MGB's PHSO programs, broadening their deployment across the operational ecosystem. This includes inpatient and ambulatory care, care continuum management, admission avoidance, and leading primary care redesign. The CPHO has P&L accountability for the VBP contracts of the MGB delivery system and its Clinically Integrated Network (CIN), while driving financial performance and strategy alignment. AS CMO of MGBHP, the leader is responsible for driving quality outcomes and financial performance in MGBHP through clinical programs and interventions. Across both roles, the leader is responsible for aligning population health clinical programs with the overall mission and goals of MGB.


Responsibilities:



Operational Oversight:

• Accountable Care Organization (ACO)- Direct the Board of Governors of and oversee the Mass General Brigham Accountable Care Organization (MGBACO) that includes over 8,000 providers across Massachusetts and New Hampshire, leading the organization to financial and clinical success in value-based care arrangements. Partner closely with the Physician Organizations (POs) of MGH/BWH, the MGB Medical Group and the affiliate physician community of Mass General Brigham Community Physicians (MGBCP).


• Population Health Service Organization -- Lead the operations of the Population Health Service Organization in providing direct clinical care as well as care management and coordination services both internal to MGB and to customers outside of MGB. Explore commercialization opportunities for this entity and its services.


• MGB Health Plan Clinical Department - Ensure high-quality care delivery and oversee the Clinical Department for the MGB Health Plan, including medical oversight and compliance, utilization management, care management, medical policy, appeals and grievances, and behavioral health


• Primary Care - In conjunction with the Chief Integration Officer, works to develop and execute the strategy of primary care transformation for Mass General Brigham. In addition, leads the strategy for primary care network development and strategic partnerships for the MGB Health Plan.


• Specialty Value-Based Payment- In conjunction with the Chief Integration Officer, works to develop specialty-based VBP programs and offerings to optimize performance in financial contracts. In addition, supports innovative programs for potential future commercialization.


• Health Plan Joint Ventures - Execute the strategy for joint ventures for the health plan to support growth and expansion of risk-based revenue through partnerships with regional health plans, provider groups, and health systems. Lead new joint venture arrangements for the health plan and/or the Population Health Service Organization.

Strategic Leadership:

• Lead the comprehensive expansion and adoption of PHSO best practices across all MGB operating entities, including ambulatory care, inpatient care, and beyond, ensuring the alignment of funds flow and care delivery models.


• Continue to evolve the working models for VBP and population health, driving change through collaboration with MGB leadership and front-line staff.


• In conjunction with the Chief Integration Officer, lead system-wide redesign of primary care operations. Guide the strategy, performance, and operational transformation of primary care to support population-level quality and VBP performance outcomes.


• Drive change management, engaging leadership, and front-line staff to implement PHSO initiatives and other efforts necessary for performance in VBP contracts.


• In partnership with MGB Medical Group and Community Physician leadership, drive the transformation of the MGB employed and affiliate ambulatory network to support the growing VBP business to enable the financial viability of Mass General Brigham

Financial:

• Accountable for VBP covering 750,000 lives and managing $425M at risk, while growing MGB's PHSO and VBP footprint.


• Support the MGB Health Plan's profitability ($2B revenue, 380,000 members).


• Drive profitability by scaling PHSO efforts, reducing expenses, and unlocking new revenue streams.


• Modernize existing systemwide VBP funds flow models and partner with primary care and medical group leadership to align provider compensation models with VBP performance.

Performance Management

• Oversee the implementation and continuous improvement of population health programs.


• In partnership with the Office of the Chief Medical Officer, establish KPIs to measure PHSO success and improve operational efficiency.


• Identify gaps in performance and create management tools to track outcomes and optimize interventions.


• Promote system-wide literacy in PHSO and VBP principles emphasizing simple, streamlined, and repeatable messaging and communications


• Collaborate with clinical and operational leaders to seamlessly integrate PHSO into clinical operations.

Team Development:

• Manage a team of over 600 people across the delivery system and the health plan


• Build, lead, and mentor a high-performing population health team, fostering a culture of collaboration, innovation, and accountability.


• Provide leadership and direction to clinical and administrative teams at each RSO, ensuring alignment with population health goals and objectives.


• Engage with providers and care teams across the health system to promote the adoption of population health strategies and best practices.

External Engagement and Advocacy:

• Represent MGB at industry forums, government panels, and community events to advocate for PHSO.


• Influence healthcare policy by engaging with regulatory bodies and policymakers.


• Foster partnerships with community organizations and stakeholders to enhance PHSO impact and health equity.


• Lead and partner with researchers across MGB to disseminate and advance knowledge in population health nationally, which is essential to MGB position as a VBP leader.


• Other duties as assigned

Qualifications

Qualifications:

• A medical degree (MD or DO) with post graduate training, board certification, and an active medical license is required. An advanced degree in healthcare, policy, business or equivalent is preferred.


• Current Massachusetts licensure or eligible for a Massachusetts Medical license without restriction


• Prior medical practice experience with the intent to maintain a modest clinical practice.


• Ten years of progressive experience in physician leadership roles (medical staff leadership, CQO, CMO, etc.) within a complex, multi-site provider/payer environment with a strong operational and contracting background


• Experience in both provider and payer settings, with a strong operational and contracting background.


• Previous success operating within an ACO, CIN or PHO managing populations under various payer arrangements is preferred.


• Experience establishing, pursuing, and monitoring appropriate process and outcome measures for key population health initiatives using a systems perspective


• Deep knowledge of analytics and using clinical and claims data to drive and optimize clinical operations


• Extensive management experience with oversight of at least 100 - 200 employees, including those directly providing care and managing operations to support care delivery


• Experience in clinical research and implementation science methodology preferred

EEO Statement

Mass General Brigham is an Equal Opportunity Employer & by embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. Apply Now