MassHealth Chief Medical Officer (CMO)
- Employer
- University of Massachusetts Medical School
- Location
- 100 Hancock Street
View more categoriesView less categories
- Executive Administration Jobs
- C-Level & Executive Directors
- Employment Type
- Full Time
- Institution Type
- Four-Year Institution
Job Details
The Chief Medical Officer (CMO) for MassHealth serves as the primary clinical leader, dedicated to ensuring that MassHealth members receive high-quality, equitable, and cost-effective healthcare services. This pivotal role involves overseeing the Office of Clinical Affairs (OCA) and providing strategic direction for clinical policy development, program management, and quality improvement initiatives. Reporting directly to the Deputy EVC of Operations, the CMO plays a key role in shaping healthcare delivery by advancing evidence-based practices, fostering innovation, and addressing health disparities to meet the needs of diverse and vulnerable populations. The CMO is part of the MassHealth Executive team and has a dual report to the Assistant Secretary for MassHealth – Massachusetts Executive Office of Health and Human Services.
The Office of Clinical Affairs (OCA) acts as the clinical arm of Massachusetts’ Medicaid program, offering leadership in policy and coverage decisions, population health assessment, and the creation of quality and equity programs for value-based care. Additionally, OCA advises MassHealth on its programs and policies and represents the agency at both state and national levels.
ResponsibilitiesClinical and Strategic Leadership:
- Serve as the Chief Medical Officer (CMO) of MassHealth and Executive Leader of the Office of Clinical Affairs (OCA), overseeing all functions and staff to ensure alignment with organizational objectives.
- Provide clinical leadership and strategic guidance to develop and implement policies and programs that deliver high-quality, equitable, and cost-effective care to members.
- Act as the chief clinical advisor to the MassHealth Director, leadership teams, program managers, and other Executive Office of Health and Human Services (EOHHS) agencies, offering expertise on policy development, program execution, vendor management, and organizational goals.
- Oversee the evaluation of new technologies, medical procedures, and treatments, and guide the development of evidence-based clinical policies to improve healthcare delivery.
- Collaborate with internal and external stakeholders to integrate data systems for monitoring healthcare quality, addressing disparities, and assessing clinical and cost-effectiveness.
- Represent MassHealth in discussions with external stakeholders on clinical policy issues and share expertise in clinical management, quality improvement, and equity initiatives with MassHealth and EOHHS programs.
Operational Oversight:
- Direct the development, implementation, and management of OCA programs, including MassHealth quality programs, equity initiatives, and medical management strategies, ensuring seamless integration with broader MassHealth objectives.
- Lead the creation and maintenance of clinical standards, best practice guidelines, and policies aimed at enhancing healthcare quality for MassHealth members.
- Oversee critical program areas, including:
- Clinical Directors team.
- Equity, Quality and Population Health. teams.
- Medical Management team.
- Prior Authorization and Utilization Management.
- Medicaid’s dental programs.
- Development of clinical components for plan and provider contracts.
- Collaborate with internal teams and external vendors to ensure adherence to federal and state regulations while maintaining high operational standards.
Compliance and Quality Management:
- Monitor compliance with all applicable regulations and provide clinical oversight of credentialing standards and processes for MassHealth providers.
- Develop strategies to meet quality improvement and equity objectives, using data-driven approaches to eliminate healthcare disparities and enhance outcomes for members.
- Implement integrated evaluation systems to measure program impact, monitor performance metrics, and drive improvements in care delivery and value-based care initiatives.
Administrative Leadership:
- Collaborate with ForHealth Consulting and UMass Chan Medical School on initiatives such as guideline development, provider education, and program evaluation to align with MassHealth’s goals.
- Drive the achievement of clinical, operational, and fiscal objectives to ensure sustainable success and program efficiency.
- Oversee recruitment, development, and performance management of senior staff, fostering a high-performing and engaged team capable of meeting organizational goals.
- Monitor organizational outcomes, refine benchmarks, and implement improvement plans to maintain high standards of quality, equity, and operational performance.
- A medical degree (MD or DO) with post-graduate training
- Board certification and an active medical license
- Current Massachusetts licensure or eligibility for a Massachusetts medical license without restriction
- Advanced degree in public health, policy, or administration.
- 10+ years in clinical leadership roles, preferably in Medicaid or managed care.
- Experience with vulnerable populations and addressing social determinants of health.
- Proficient in data analytics, quality measures, and healthcare system development.
*LI-VD1
Organization
Realize Your Opportunities – A Career at UMASS Medical School
Inside Workings at UMASS Medical School
The University of Massachusetts Medical School (UMMS), the Commonwealth's only public medical school, is proud of our role in serving the people of Massachusetts. Although, its the inside workings of UMMS that makes the difference.
Mission and Culture
- We’re serious about our mission and about our people.
- Real World Impact - Our people get excited about our mission of real-world impact in health sciences education, research and public service.
- International Prominence and New Opportunities - As this institution has grown to national – and international – prominence, we’ve found new opportunities to train tomorrow’s physicians, nurses and scientists, discover causes of and cures for disease and help improve the quality of health care.
- Deep Commitment - With our clinical partner, UMass Memorial Health Care, and our other teaching affiliates, we share a deep commitment to national distinction in patient care.
- Valued Partnerships – UMMS partners with Commonwealth Medicine, the health care consulting arm of UMMS. Also, UMMS partners with MassBiologics in scientific collaborations, technology management and creating partnerships for the development of products for the benefit of patients. These valued partnerships help us to provide services and programs to help meet our needs at UMMS and the public.
- Proud Contributors - People at UMMS enjoy the feeling of going to work every day knowing what they do is truly important and worthwhile.
- Complementary and Inseparable - These varied parts of our mission and culture are complementary and inseparable.
Careers
UMMS, the state’s first and only public academic health sciences center, educates physicians, scientists and advanced practice nurses to heal, discover, teach and care, with compassion. UMMS is a world-class institution with opportunities to match. 
Competitive Compensation – UMMS offers salaries that are competitive with Worcester-area employers. When combined with our generous benefits, perks, and paid time off, many job seekers are surprised to find a total rewards package that matches or exceeds their current situation.
Targeted Hiring Process – At UMMS, there are actually multiple hiring processes for different segments of our workforce. In nearly all cases, UMMS hiring process is decentralized, with qualified candidates screened and referred to an academic officer or manager with hiring authority.
24/7 Access to Employment Opportunities – iCIMS is our online job search and application system. iCIMS is available 24/7 to provide you with a convenient and up-to-date view of the available employment opportunities across our campuses. Updates are made daily and include all faculty and non-faculty position listings from every school and department within the UMMS. When you identify a position you are interested in and qualified for, apply online. New opportunities become available frequently so it pays to check back often!
Benefits
With outstanding benefits, competitive pay, extensive learning opportunities, and a stimulating and attractive work environment, UMMS may be exactly the employer you’ve been looking for.
• Superior Benefits - UMMS offers a wide range of benefits and perks that invite comparison with the best employers in the Worcester area – and with academic institutions anywhere. UMMS provides superior medical and dental coverage for you and your family, fully funded retirement plans, generous time off, a Tuition Assistance Plan – and much more.
• People Centered - UMMS is an employer, but it is also a community. Its comprehensive medical and dental benefits, retirement plans, and even paid holidays reflect an institution built around people, with a deep respect for their differences and needs.
• Commitment to Healthy Living - UMMS provides resources to help you balance work and life and encourages healthy living through great programs and discounts for fitness, physical activity, weight management, nutritional counseling and general wellness available through our health insurance plans.
• Breadth of Offerings - Above all, the breadth of UMMS offerings set the School apart and makes it an environment favored by all sorts of smart, career-savvy people.
Apply for a Job
As an equal opportunity and affirmative action employer, UMMS recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds.
Online - To view all job opportunities and apply online, visit www.umassmed.edu/hr and click on the “Careers” tab.
Start Now and Realize Your Opportunities!
A History of Making Vital Improvements - UMASS Medical School Milestones
1962: Legislation establishes University of Massachusetts Medical School
1970: First medical students begin classes in Shaw Building
1974: First class graduates 16 MDs
1979: PhD program begins
1986: Graduate School of Nursing opens
1986: PhD program becomes Graduate School of Biomedical Sciences
1994: Graduate School of Nursing initiates PhD program
1998: UMass Clinical System and Memorial Health Care merge to form UMass Memorial Health Care
2001: Lazare Research Building opens
2002: Campus Modernization begins on the University Campus
2004: Graduate Entry Pathway Program established at the Graduate School of Nursing
2005: PhD Program in Clinical & Population Health Research established at the Graduate School of Biomedical Sciences
2005: Massachusetts Biologic Laboratories opens new manufacturing and filling facility in Mattapan
2006: Craig Mello, PhD, Blais University Chair in Molecular Medicine and Howard Hughes Medical Institute Investigator, is awarded the Medical School's first Nobel Prize. Dr. Mello shared the 2006 Nobel Prize in Physiology or Medicine with Andrew Fire, PhD, of Stanford University, for their discoveries related to RNA interference.
2007: Michael F. Collins, MD, is named chancellor and Terence R. Flotte, MD, is named dean of the School of Medicine.
2009: Groundbreaking for the Albert Sherman Center, a 500,000-square-foot research and education facility slated for completion in 2012.
2010: Ambulatory Care Center opens
2012: The Albert Sherman Center, a 500,000-square-foot research and education facility, completed and opens
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