• Dr. Rahul Rajkumar is currently Chief Medical Officer at CareFirst BlueCross BlueShield
  • Has led health cost management and quality efforts at CareFirst and in federal government
  • Begins Blue Cross NC role in early 2018

Durham, NC – Dr. Rahul Rajkumar, who has led health care quality and cost management efforts for the federal government and a private insurer, has been named Senior Vice President and Chief Medical Officer at Blue Cross and Blue Shield of North Carolina.

Dr. Rajkumar comes to Blue Cross NC after serving as Chief Medical Officer and SVP for CareFirst BlueCross BlueShield. At CareFirst he has developed and led programs addressing costs and health care improvement. These include initiatives related to model physician practices known as patient-centered medical homes, behavioral health, telemedicine and substance abuse treatment.

Before joining CareFirst, Dr. Rajkumar served four years as Deputy Director of the Center for Medicare and Medicaid Innovation. He led federal efforts to promote value-based payments for physicians and hospitals resulting in signing tens of thousands of agreements with providers worth billions of dollars. He also oversaw programs promoting primary care, the initial federal pilots for Accountable Care Organizations (ACOs), bundled payments for health care procedures and patient safety initiatives.

“I’ve worked closely with Rahul and have seen firsthand how he can bring promising ideas to reality to provide real improvements for patients and the health care system,” said Blue Cross NC President Dr. Patrick Conway. “He’s done so in a way that brings lasting cooperation between doctors, hospitals and insurers. He’s the ideal person to lead our efforts to work with health care providers to ensure our members are getting high quality, cost-effective care and the best possible outcomes.”

Dr. Rajkumar will take on the Blue Cross NC role in early 2018. He will lead areas that include contracting and relationships with health care providers, medical policy, corporate pharmacy, appeals, care management and health care. Blue Cross NC medical cost and care initiatives include quality-based provider contracts, incentives for model primary care practices, bundled payments for some surgical procedures and a cost transparency tool for consumers.

“I am thrilled to join this team, which is already known nationally for its innovative work and member focus—and I look forward to the great work we will do together to improve health care for millions of people in North Carolina and beyond,” Dr. Rajkumar said.

Dr. Rajkumar has bachelor’s degree in history, a law degree and a medical degree – all from Yale University. During his work at CareFirst and the federal government, he has worked as an attending physician at the Veterans Affairs Hospital in Washington, DC.  Dr. Rajkumar is an innovative leader who will help lead Blue Cross North Carolina into the future.


About Blue Cross and Blue Shield of North Carolina:

Blue Cross and Blue Shield of North Carolina improves the health and well-being of our customers and communities through innovative health care products, insurance, services and information to more than 3.6 million members, including approximately 1 million served on behalf of other Blue Plans. Since 1933, we have worked to make North Carolina a better place to live through our support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross online at bcbsnc.com. All other marks are the property of their respective owners.