Exciting opportunity for a skilled physician consultant to lead and continuously evolve the Blue Cross Blue Cross Blue Shield of Massachusetts (BCBSMA) support model for our provider partners, assisting them with meeting their quality and efficiency improvement goals and care delivery innovations through collaboration. Since the inception of the AQC (Alternative Quality Contract), BCBSMA has committed to partnering with our provider groups to ensure they have the data, reporting, and consultative support required to make significant strides in quality and cost. In fact, many AQC leaders credit the support model as one of the differentiators for BCBSMA. Our collaborative forums and best practice sharing have allowed many of our providers to achieve improved levels of success. In this newly created position, the Director will lead the implementation of new tools and more customized support models, ensuring that our provider partners have the tools and knowledge they need to meet their own goals for performance.

Major Responsibilities:

• Lead a cross-functional team in the development of the next level of analytics and reporting tools that will assist provider groups with significantly improving quality and trend in commercial or Medicare risk contracts. Will require working with internal and external resources.
• Serve as the thought leader for the development of provider-facing analytics tools
• Serve as the senior clinical lead responsible for coaching the entire AQC support team and tailoring our support strategy to achieve effective and collaborative relationships with each provider organization’s clinical leadership
• Coach AQC support clinicians on core consulting skills and educate on key topics such as best practices for optimizing utilization, site of care shifting, physician engagement, incentive development, and quality measurement
• Develop an annual education plan that will ensure that AQC clinical leaders are well versed and confident to lead changes in their own organization on key population health success factors
• Develop, test, and then implement provider focused strategies that drive member engagement
• Lead annual assessment of AQC groups’ population health capabilities and educate internal constituents on the state of our network and update/tailor the AQC support model to enhance performance when appropriate.
• Provide expert consulting to provider organizations in the BCBSMA network. Consulting will focus on the following areas: physician engagement, incentive programs, coaching in identifying key financial or quality opportunities, facilitating consensus on key opportunities, evaluating current efforts, developing analytics to support new idea generation
• Represent BCBSMA and speak about our Alternative Payment Programs at local, regional, and national forums

Education/Relevant Experience:

• MD degree with board certification required
• Current and valid unrestricted license to practice medicine in the state of Massachusetts (or ability to apply for a license).
• Advanced degree in business, health policy or public health (i.e. MBA, MPP, MPH, or MHA) preferred.
• Minimum two years of management consulting or similar experience required; population health experience preferred
• Minimum of three years of clinical experience in a practice setting, prefer a primary care setting.
• Solid understanding of population health strategies, best practice models, medical clinical practice, quality improvement, and practice redesign.