Director, Managed Care
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Job Description
Director, Managed Care overseeing contracting activities and payer strategy at City of Hope. Leading operational efforts to promote patient access and achieve revenue goals in a healthcare environment.
Responsibilities:
- 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.
- 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:
- 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.
- Skills: 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.
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