[Hiring] Director, Managed Care @City of Hope

Role Description

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. 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.

• 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.

Qualifications

• Minimum Education: Master’s Degree in Business Administration, Health Care Administration, Public Administration, Juris Doctorate, or another relevant advanced field required.
• Minimum Experience: 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.
• Preferred Experience: 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.

Requirements

• 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.

Benefits

City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location. City of Hope is an equal opportunity employer. To learn more about our Comprehensive Benefits, please CLICK HERE .