Location: Somerville,MA, USA
The Population Health Management (PHM) department at Mass General Brigham (MGB) aims to translate the evolving needs of the healthcare landscape into innovative solutions to better serve individuals, communities, and organizations. PHM is responsible for care provided under Commercial, Medicare and Medicaid risk contracts covering over 700,000 patients cared for across a broad network of owned and affiliated practices.
In the healthcare industry, we are in a time like no other. Experts estimate that healthcare will evolve more in the next few years than it has in the last 50 years. We have seen governments, employers, and families struggle in the face of rising healthcare costs and a fragmented healthcare system. Patients and communities need more convenient, more affordable, and higher quality care.
We are building a team that can reimagine healthcare and design care models that meet the needs of the people we serve. We are bringing a fresh perspective and a unique approach to create impact for the greater good. By bringing together people from various disciplines and ideas from different industries, we're seeking to address the complex challenges within our healthcare system and leaning forward into a new era of healthcare.
As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. At Mass General Brigham, we are dedicated to diversity, equity and inclusion as we aim to reflect the diversity of the patients in our local community. We believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.
Responsibilities:
The Associate Chief Population Health Officer will lead the clinical strategy of the Clinically Integrated Network (CIN)/Accountable Care Organization (ACO) within Mass General Brigham's Population Health Management (PHM) department. This role is pivotal in driving excellence in value-based care delivery, enhancing clinical quality, and ensuring financial sustainability through effective risk contract management.
Physician Leadership:
1. Strategic Leadership and Clinical Oversight
* Serve as the clinical lead, with the guidance of the Chief Population Health Officer, to provide advice and support to
1) PHM Finance team and the MGB payer contracting team on value-based care risk contracts and government payer policy
2) represent PHM initiatives in contract negotiations and meetings with payers
3) guide evaluation and participation in Medicare and Medicaid risk agreements
* Lead efforts in partnership with MGB Finance to define and negotiate strategy, cost, and quality metrics for the internal performance incentive framework (IPF), ensuring alignment of the MGB ACO employed and affiliated network with MGB system quality and performance goals.
* Collaborate with the Office of the Chief Medical Officer to align metrics, reporting and strategy to ensure sustained performance in quality and equity in MGB risk contracts.
* Ensure clinical integration standards are met, developing a robust program of quality improvement across the network, and fostering a culture of continuous improvement.
* Oversee activities of PHM medical directors, provide mentorship and development, and ensure medical directors are leading population health efforts, including establishing clear timelines and tangible deliverables in alignment with administrative counterparts.
* Provide clinical advisement in the building of new clinical interventions targeted at specific improvements in avoidable utilization, inform implementation of evidence-based clinical protocols and workflows, and develop key performance indicators (KPIs).
* Collaborate with Digital Team supporting Electronic Health Record, AI development and vendor decision making to support improvement in patient care and clinical workflows.
2. Performance and Risk Management
* Partner with PHM Head of Finance on review of risk contract performance by line of business, identify trends and clinical strategies to improve patient care and financial performance.
* Guide medical directors and network team to review IPF data to identify performance gaps, develop action plans to address gaps, and monitor/evaluate outcomes and facilitate the coordination of this work with broader clinical performance management work at the practice and unit level
* Partner with PHM Finance, MGB contracting, and PHM Product to assess new billable service opportunities and develop strategy and plan to pursue opportunities.
* Stay abreast of best practices nationally and regionally, educate the department and the network, and update the clinical strategy to reflect these learnings.
* Chair MGB ACO Quality and Clinical Performance Board Committee quarterly and represent PHM in this committee and related workgroups and sub-committees.
3. Network Engagement and Feedback
* Actively engage with the Primary Care and ACO network, gathering feedback, themes, and questions to inform strategic decision-making and operational adjustments.
* Host educational forums with the network to keep them abreast of contract and regulatory changes, contract requirements, and best practices.
* Collaborate with clinical leadership across practices to achieve success in value-based care metrics, including designing corrective action plans for underperforming areas.
* Collaborate with clinical leadership across the network to design and build innovative PHM interventions to scale across the MGB ACO network.
* Provide leadership, direction, and support to the network clinical team, and medical directors to ensure alignment with PHM's objectives and operational goals.
4. Clinical Operations and Process Improvement
* Partner with clinical operations and strategy leadership to provide feedback for clinical program design, with the guidance of the Chief Population Health Officer.
* Proactively share evidenced-based practices to optimize current clinical operations for ongoing process improvement to achieve better patient outcomes and expense sustainability.
* Develop KPIs, review, and monitor performance KPIs with the PHM Clinical Operations team to assess effectiveness of interventions and identify areas of improvement to drive improvement in value- based care risk contract performance.
* Identify analytics opportunity and guide analytics team to improve reporting to drive clinical operations.
* Support evaluation of existing and new programs in collaboration with analytics/evaluation teams.
Qualifications:
* Respected and practicing clinician with 10 years of MD or similar degree, with at least five years of leadership experience in population health management or a related field.
* Extensive experience in negotiating payer risk contracts, designing and executing clinical quality metrics, and leading value-based care initiatives.
* Proven track record of managing clinical teams and fostering a collaborative, high-performing environment.
* Strong leadership skills, with the ability to influence change and drive clinical excellence across a diverse network.
* 10 years progressive experience with knowledge of the healthcare industry, including regulatory and compliance requirements, and a commitment to upholding the highest standards of patient care and safety.
* Demonstrated knowledge and expertise in population health management concepts, methodologies, and tools, such as risk stratification, care coordination, care management, quality improvement, and value-based care.
* Strong analytical, problem-solving, and decision-making skills, with the ability to use data and evidence to inform and guide PHM initiatives.
* Excellent communication, interpersonal, and presentation skills, with the ability to build and maintain positive and productive relationships with diverse stakeholders.
* Highly motivated, adaptable, and collaborative, with a passion for improving the health and well-being of populations.
* Strong experience in change management and collaboration with multiple senior clinical and administrative stakeholders across disciplines to effectively drive system-level changes and tangible results