Blue Cross Blue Shield of Massachusetts – VP & Medical Director, Clinical Programs & Strategy

ZurickDavis Published: November 7, 2017
Job Type


Blue Cross Blue Shield of Massachusetts (BCBSMA) seeks a Vice President & Medical Director, Clinical Programs and Strategy (VPMD). The VPMD is one of five senior physicians in the Health and Medical Management Division (HMM), who are direct reports to the Chief Physician Executive. The Division is the nexus of all medical operations and policy deliberation. The Division has 437 staff, including clinical and non-clinical professionals and a budget of $42M.

Reporting to the Chief Physician Executive of BCBSMA, the Vice President & Medical Director, Clinical Programs and Strategy is a new role in the HMM Division that has program and policy responsibilities in HMM. The VPMD will need to collaborate across the organization for many initiatives. S/he will be responsible for the directing the Medical Policy group, Clinical Quality and Compliance programs, the Clinical Pharmacy program, and co-chair the Trend Oversight Team. The VPMD has 2 direct reports and 7 FTEs in Medical Policy and 23 FTE in Quality and Compliance, Cost and Trend and an operating budget of $2.75M.

The ideal candidate for this VP & Medical Director role will be a physician with extensive experience implementing initiatives and business strategies that positively impact clinical quality and/or cost outcomes. S/he must have a substantive clinical practice background, strong operational skills and experience in core medical management areas. Knowledge of Medicare and Commercial medical management activities and regulatory requirements is highly desirable. The best candidates will be intellectually inquisitive, committed to the benefits of population management from the health plan platform, with the experience and skills to make a strong case for complex medical policy issues.

Blue Cross Blue Shield of Massachusetts is a community-focused, value driven, tax-paying, not-for-profit health plan headquartered in Boston. With $6.5B in premium revenue, BCBSMA is the health plan selected by more than 25,400 Massachusetts employers and has 2.9 M members. 800,000 of these members are from outside Massachusetts. The product lines include HMO/POS, PPO/Indemnity, Senior Products/Medicare and a dental plan. For more information, please visit

Blue Cross Blue Shield of Massachusetts has retained the services of ZurickDavis to assist in this search. A full description is available at the Current Engagements tab of We invite interested parties to send a resume and cover letter to For additional questions, please contact Ellen Mahoney at 781.938.1975. All contact with ZurickDavis will remain confidential.

Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

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