Director, Value-Based Care & Payor Strategy Lead

Methodist Le Bonheur Healthcare; Memphis (TN); On-site; USD 140,000 - 190,000; Full time

Job summary

Methodist Le Bonheur Healthcare in Memphis is seeking a Director, Clinical Quality & Payor Strategy to lead strategic initiatives across Medicare Advantage and value-based care programs. The role requires deep expertise in quality metrics, payer partnerships, and EHR workflows to drive performance and ensure CMS-aligned compliance.

You will collaborate with internal teams, external payors, and physicians to optimize care delivery, monitor visit compliance, and build scalable workflows.

Qualifications

• Experience with Medicare and value-based programs.
• Experience in people management and program management.
• Knowledge of CMS-aligned quality frameworks.
• Strong strategic planning and workflow development skills.

Responsibilities

• Leads strategic planning and execution of value-based quality initiatives across all payors (CMS, Medicare Advantage, commercial).
• Serves as subject matter expert for internal quality metrics and EHR workflows, providing education, troubleshooting, and optimization support.
• Responsible for achieving quality performance for ACOs, coordinating efforts with payors, Healthchoice, and physicians.
• Develops and manages operational workflows for strategic programs such as UHC Fastpass, MdRev, FindHelp, and Aledade, aligning with organizational goals.
• Develops and drives management of operational workflows for chronic care management, remote patient monitoring, patient-centered medical home, and transition of care.
• Coordinates with external partners and internal stakeholders to expand services and support program growth.
• Facilitates quality governance by organizing committee meetings, preparing agendas, and presenting updates.
• Provides strategic and operational support to Population Health teams, including clinical staff and program managers.
• Monitors compliance with payor-specific visit requirements and documentation standards, ensuring alignment with CMS and contract expectations.
• Partners with Decision Support teams to provide performance tracking and feedback for continuous improvement across clinics and teams.

Skills

Medicare Advantage

CMS quality metrics

Strategic planning

Cross-functional coordination

Stakeholder engagement

EHR workflows

Performance improvement

People management

Education

Bachelor's Degree Healthcare Administration

Bachelor's Degree Nursing

Bachelor's Degree Public Health

Master's Degree

Tools

Epic EHR

Population health tools

Job description

Methodist Le Bonheur Healthcare in Memphis is seeking a Director, Clinical Quality & Payor Strategy to lead strategic initiatives across Medicare Advantage and value-based care programs. The role requires deep expertise in quality metrics, payer partnerships, and EHR workflows to drive performance and ensure CMS-aligned compliance.

You will collaborate with internal teams, external payors, and physicians to optimize care delivery, monitor visit compliance, and build scalable workflows.