MassHealth Chief Medical Officer (CMO)

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MassHealth Chief Medical Officer (CMO) Job Number : 2025-47548

Category : Administrative Professional

Location : North Quincy, MA

Shift : Day

Exempt / Non-Exempt : Exempt

Business Unit : ForHealth Consulting

Department : ForHealth Consulting - Office Of Clinical Affairs - W401300

Job Type : Full-Time

Num. Openings : 1

Post Date : Jan. 12, 2025

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.

Clinical 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 :

Compliance and Quality Management :

Minimum Qualifications :

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