Director Medicare Operations Jobs (NOW HIRING)

Hours of Work :

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Job Description :

Job Purpose:

• The Medical Director, MSSP ACO Program is a key clinical leader responsible for overseeing and driving the clinical performance and operational success of Methodist Health System's Medicare Shared Savings Program (MSSP) Accountable Care Organization and other Value-based Care (VBC) initiatives.
• This leader will serve as the clinical champion for value-based care transformation, ensuring alignment between quality, cost, and patient outcomes. The Medical Director provides clinical leadership to employed and affiliated physicians participating in the ACO, guiding initiatives that improve care coordination, reduce unnecessary utilization, and enhance patient experience across the continuum of care.
• Support the mission, vision, values and strategic goals of Methodist Health System.

Job Requirements:

Education:

• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) required.
• Advanced degree in Healthcare Administration, Public Health, or related field (preferred).

Licenses and/or Certifications:

• Current, unrestricted Texas medical license (or eligibility to obtain).
• Board certification in Internal Medicine, Family Medicine, Geriatrics, or another relevant specialty.

Work Experience:

• 8-10 years of clinical practice experience with progressive leadership responsibilities.
• Prior experience in value-based care, ACOs, population health, or clinical integration initiatives strongly preferred.
• Proven track record of success in quality improvement, physician engagement, and cost containment programs.
• Experience with CMS MSSP quality reporting, risk adjustment, and performance improvement preferred.

Related Work Experience and Other Skills:

• Strong understanding of healthcare economics, CMS payment models, and ACO operations.
• Data-driven mindset with the ability to translate analytics into clinical actions.
• Excellent communication, collaboration, and physician engagement skills.
• Strategic thinker with the ability to operationalize complex initiatives.
• Commitment to health equity, patient-centered care, and Methodist Health System's mission of compassionate service.

Key Performance Indicators (KPIs)

• Achievement of MSSP shared savings targets and quality score benchmarks.
• Reduction in avoidable hospital admissions and readmissions.
• Improved patient experience (CAHPS) scores.
• Increased provider engagement and participation in ACO initiatives.
• Accuracy and completeness of risk adjustment and documentation.

Job Roles:

Clinical Leadership & Strategy

• Provide strategic clinical leadership for Methodist Health System's MSSP ACO program, ensuring compliance with CMS requirements and advancing ACO goals.
• Lead clinical strategy to improve quality metrics, patient outcomes, and total cost of care performance under the MSSP and other shared-savings programs.
• Serve as the liaison between clinical staff, administration, and the VBC leadership team to align operations with ACO performance objectives.
• Identify and develop care models and interventions to improve chronic disease management, reduce readmissions, and address social determinants of health (SDOH).

Quality & Performance Management

• Oversee the measurement, reporting, and improvement of CMS quality metrics under the MSSP, including preventive health, chronic condition management, patient experience, and utilization measures.
• Work with data analytics teams to interpret performance dashboards and identify actionable insights for physician and care team improvement.
• Lead or participate in root cause analyses, care variation reduction projects, and performance improvement initiatives.
• Ensure timely and accurate completion of documentation, coding, and risk adjustment activities to optimize accuracy in CMS reporting and attribution.

Physician Engagement & Education

• Build strong relationships with employed and independent physicians participating in the ACO to promote engagement and accountability for value-based care goals.
• Educate providers on MSSP and other VBC requirements, performance measures, documentation best practices, and strategies to enhance clinical and financial results.
• Facilitate regular provider meetings, clinical education sessions, and performance feedback forums.
• Serve as a trusted clinical advisor and advocate for physician partners across Methodist Health System's network.

Care Coordination & Population Health

• Partner with care management, transitional care, and post-acute leadership to develop and optimize workflows that improve patient transitions, reduce readmissions, and close care gaps.
• Lead development of patient-centered strategies for high-risk, high-cost populations, including initiatives for chronic disease management, telehealth integration, and home-based care models.
• Promote effective use of care coordination resources, data tools, and clinical decision support systems.
• Collaborate with community organizations and external partners to address SDOH and enhance care access for Medicare beneficiaries.

Data, Analytics & Reporting

• Partner with analytics and finance teams to monitor cost and quality outcomes and identify opportunities for shared savings.
• Translate data insights into clinical and operational improvement plans.
• Participate in quarterly performance reviews with CMS and provide leadership input for ACO governance and reporting.
• Support the creation of annual MSSP strategic and operational plans, including goal setting and key performance indicators.

Collaboration & Governance

• Serve as a key member of the ACO Board, providing updates on clinical performance, opportunities, and risk areas.
• Collaborate with Methodist Health System executives, hospital leaders, and physician governance bodies to advance system-wide value-based care objectives.
• Represent Methodist Health System's ACO at local, regional, and national MSSP forums and conferences.
• Completes other duties as assigned.

Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America by Modern Healthcare, Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we've earned:

• Great Place to Work Certified2026-2027

• Glassdoor's Best Places to Work 2025 & 2026

• Glassdoor's Best Places to Work in Healthcare, Biotech & Pharma2026

• TIME's Best Companies for Future Leaders 2025 & 2026

• Newsweek's America's Most Admired Workplaces 2026

• Glassdoor's Best-Led Companies 2025

• Fortune Best Workplaces in Health Care 2025

• Military Friendly Gold Employer 2025

• Becker's Hospital Review 150 Top Places to Work in Healthcare 2025

• Newsweek's Americas Greatest Workplaces 2025