Fallon Health seeks a forward-thinking, dynamic, and seasoned physician executive to serve as its Senior Vice President & Chief Medical Officer (SVP & CMO). As an integral member of the executive leadership team, the SVP & CMO will report to the President and CEO, Richard Burke.  The SVP & CMO is a key member of the executive management team, engaged in defining the overall business strategy and direction of the organization.  The SVP & CMO provides medical oversight, expertise, and leadership to ensure the delivery of affordable, high quality healthcare services.  The SVP & CMO will be responsible for the strategic development and implementation of innovative clinical programs, while overseeing all medical management functions to ensure the quality and cost-effectiveness of healthcare services received by Fallon members.

Founded in 1977, Fallon is Headquartered in Worcester, MA, and is both an insurer and provider of care.  In addition to offering innovative health insurance solutions, Fallon excels at creating unique healthcare programs and services that provide coordinated, integrated care for older adults and individuals with complex health needs.  With a predominant focus on government-sponsored plans, Fallon’s product portfolio includes a variety of health plan options, which includes Medicaid and Medicare Advantage plans. Fallon also offers a Medicare Advantage Special Needs Plan/Senior Care Options program, called NaviCare. As a provider of care, Fallon offers a Program of All-Inclusive Care for the Elderly, called Summit ElderCare.

Fallon has consistently been rated among the nation’s top health plans by the National Committee for Quality Assurance for its HMO and Medicaid products, and by the Centers for Medicare & Medicaid Services for its Medicare Advantage products.  Fallon has a strong balance sheet; high cash investments and reserves are at an all-time high.  Fallon has projected revenues of $1.8 Billion for 2021 and has approximately 1,200 employees.

The SVP & CMO is a crucial position in Fallon, and requires a mature physician executive who can work in a nimble, unpretentious culture that has high expectations for leadership.  Fallon seeks someone who will embrace working in a highly collaborative team environment. The SVP & CMO will be open to compromising, teaming, and working side-by-side with other senior leaders and their teams.  The SVP & CMO will have highly developed executive skills and a track record of successful project management and execution as well as engaging internal and external stakeholders in a variety of different settings.  The SVP & CMO must understand managed Medicaid/Medicare products, ACOs, and have strong knowledge of medical and behavioral health utilization, medical loss ratios, pharmacy, quality, claims, and disease management.

Interested parties should direct all nominations and resumes to the consultants supporting this search, Tom Quinn and Carl Fitch, through the WittKieffer Candidate Portal by clicking here.  For additional questions, please contact Carl Fitch preferably via email at cfitch@wittkieffer.com.