Director, Managed Care

City of Hope

4h

About The Position

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.
The Director, Managed Care will plan and execute managed care contracting activities and develop payer strategy to promote patient access, in order to achieve annual budgeted net patient revenue goals of City of Hope National Medical Center and City of Hope Medical Foundation. This role serves as the managed care leader for managed care operations, and payor expert supporting City of Hope’s clinical sites and City of Hope’s community growth and expansion.
As a successful candidate, you will:
Directly oversee all aspects of the day-to-day operations of the Managed Care team and department for COH within an assigned state/market.
Manage relationships with state-level payer relationships, performance management, and contract compliance.
Align payer operational strategy with enterprise growth initiatives.
Identify revenue lift opportunities through improved operational enforcement of contracts.
Provide recommendations and collaborate with internal stakeholders to monitor contract performance and renegotiate as needed.
Monitor, evaluate and negotiate new and existing contractual arrangements to conclusion for the City of Hope enterprise

Requirements

• Master’s Degree in Business Administration, Health Care Administration, Public Administration, Juris Doctorate, or another relevant advanced field required
• 10+ years working in managed care with experience directing the managed care functions of a managed care organization or academic health care institution nationally recognized oncology program
• 7 years of experience in a leadership capacity
• Financial acumen and strong skills in financial analysis.
• Demonstrated strong written and verbal communications skills.
• Strong negotiation skills and deep knowledge of physician and hospital reimbursement

Nice To Haves

• At least fifteen years of experience working at a nationally recognized cancer center, large oncology physician practice or academic center with a top tier oncology department.
• Experience contracting for bone marrow/stem cell transplants, CAR T and immunotherapy.

Responsibilities

• Directly oversee all aspects of the day-to-day operations of the Managed Care team and department for COH within an assigned state/market.
• Manage relationships with state-level payer relationships, performance management, and contract compliance.
• Align payer operational strategy with enterprise growth initiatives.
• Identify revenue lift opportunities through improved operational enforcement of contracts.
• Provide recommendations and collaborate with internal stakeholders to monitor contract performance and renegotiate as needed.
• Monitor, evaluate and negotiate new and existing contractual arrangements to conclusion for the City of Hope enterprise

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 1,001-5,000 employees