Tom Weigel

About Tom Weigel

Physician executive with over 20 years of experience spanning care delivery, payer operations, and healthcare technology, including direct experience designing clinical data systems and EMR-driven workflows. Deep expertise in translating clinical policy, utilization management, and reimbursement frameworks into scalable clinical and administrative workflows across payer–provider interactions. Partner closely with analytics, technology, and vendor teams to operationalize clinically defensible logic within systems used at scale in real-world provider environments. Recognized for bridging clinical, operational, and technology domains to drive adoption of solutions that improve provider experience and reduce administrative friction.

Experience

1. Vice President and Chief Medical Officer

   Blue Cross and Blue Shield of Vermont

   Sep 2022 — Present · VT, US

   Serve as Chief Medical Officer for Blue Cross and Blue Shield of Vermont, leading enterprise clinical strategy across utilization management, medical policy, quality, pharmacy, and value-based care. Responsible for 80 FTEs and $19M budget.Focus on aligning clinical policy, utilization management, and reimbursement approaches with real-world provider workflows, improving both affordability and provider experience. Partner with analytics, technology, and external vendors to translate clinical and operational requirements into scalable workflows across prior authorization, claims, and administrative processes.Lead initiatives in value-based care, population health, and site-of-care optimization, delivering over $200M in annual savings while maintaining quality and access. Serve as a clinical interface with providers, health systems, and regulators to support adoption of new models and reduce administrative friction.

Education

• University of Wisconsin-Madison

  BS with Honors and Distinction, Philosophy, Molecular Biology

  1987 — 1991

• Harvard Medical School

  Massachusetts General Hospital - Residency in Psychiatry

  1996 — 1999

• MIT Sloan School of Management

  Master of Business Administration - MBA, Business Administration and Management, General

  2015 — 2017

• Harvard Medical School

  Boston Children's Hospital - Fellowship in Child Psychiatry

  1999 — 2001

• University of Wisconsin-Madison

  Doctor of Medicine (M.D.), Medicine

  1991 — 1995

Skills

• Healthcare Information Technology (Hit)
• Healthcare Consulting
• Hospitals
• Mental Health
• Medicine
• Social Services
• Adolescents
• Clinical Research
• Psychotherapy
• Neuroscience
• Psychiatry
• Leadership
• Psychology
• Healthcare Effectiveness Data and Information Set (Hedis)
• Treatment
• Group Therapy
• Therapists
• Public Health
• Healthcare