Key Work Experience

Massachusetts Medicaid medical director for three years, with clinical oversight for 1.6m members and 40% of state budget

Federal health center Chief Medical Officer for $100m Medical Affairs budget with oversight of 14 centers in NYC

14 years of clinical experience with expertise in Value-Based Care, Quality, Population Health, and award-winning Medical Communication

2018-2019

Chief Medical Officer and Vice President of Medical Affairs

•Medical Affairs leadership for NCQA-certified medical home (PCMH) Federally Qualified Health Center (FQHC) with $100m budget, 15+ sites, >700 staff, 85,000 patients with subspecialty care including pharmacy, psychiatry, dental, vision, women’s health, pediatrics, nutrition •Opening of a 340B pharmacy •Oversight of all changes to institutional formulary •Opening of behavioral health site integrated with primary care •Annual quality reporting to Uniform Data System (UDS) •Revised operating hours for optimized revenue stream

2013-2016

Associate Medical Director


•Led MassHealth ACO (Accountable Care Organization) quality strategy and measure slate development for successful bid for $1.8b in new funding from CMS •Led state-wide stakeholder engagement for DSRIP (Delivery System Reform Incentive Payment program) with oversight of cross-functional teams in matrixed setting •Provided oversight of managed care organizations within MassHealth  •Conducted cost effectiveness analyses for new devices, pharmaceuticals, and procedures •Led Children’s High Risk Asthma Bundled Payment initiative for MassHealth •Evaluated behavioral health screening tools for primary care •Expert witness for grand jury trial

2007-Current

Academic Physician


•Principal Investigator on community health grant for reducing disparities in adult coronary artery disease per Culture of Health •Provided pediatric clinical care in coordination with maternal health  •Led pharmacy protocol implementation for inpatient service •Contributed to redesign of electronic discharge template in EPIC •Designed and implemented clinical protocols •Invited consultant to Connecticut Department of Public Health on special needs population •Provided oversight to nurse practitioners •Developed national and state curricula •Designed two novel health policy electives

 

Projects

Portfolio of Work
(Selected)

 

Clinical Lead, $1.8b successful bid to Centers of Medicare and Medicaid Services to create Accountable Care Organizations in Medicaid in Massachusetts

Patient Centered Medical Home

Multiple projects ranging from curriculum design for clinicians to behavioral health integration to back end HIT design for data transfer to support integration

Social Determinants of Health HIT Solution

Design a novel Health Information Technology (HIT) solution to capture Social Determinants of Health (SDoH) data from medical records for clinical quality and population health outcomes.

Design of public health text messaging for Maternal-Child Health (MCH) to expecting and new mothers

Operating Hours Rightsizing

Used combination of quantitative and qualitative data to assess operating hours for outcomes of patient access, clinical revenue, and staffing ratio. Proposed new operating model approved by board.

Quality improvement to increase postpartum visit rates within Medicaid

Curriculum Design and Evaluation

Design and evaluation of four curricula on Patient Centered Medical Home (PCMH)

Oversight of first Advance Practice Nurse fellowship in New York with doubling of size and expansion of practice scope

Holistic Heart

Principal Investigator for Culture of Health model interfaith community health grant for six, diverse underserved communities in Chicago to deliver cardiac health resource and education in partnership with community champions

MedTech Patnership

Relationship management and strategic design of anticipated $500m international MedTech collaboration between Harvard-affiliated innovators and low to middle income countries

CV and Resume Files

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Resume

CV (Full)

 

Nehal Group

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