Executive Director, Payer Relations
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Job Description
Executive Director overseeing managed care operations and payer performance at City of Hope. Leading operational execution and payer issue resolution across various healthcare facilities.
Responsibilities:
- Function as the enterprise authority on payer operational governance, coordinating cross-functional teams to ensure payer compliance, dispute resolution, and performance improvement.
- Ensure contract terms are operationalized effectively, payer obligations are enforced, financial targets are met, and performance deficiencies are escalated and resolved.
- Lead market-level managed care leadership across California and CAP markets and establish enterprise standards for payer performance oversight, contract enforcement, and managed care operational excellence.
- Provide strategic direction through Directors and Senior Managers across multiple states.
Requirements:
- Master’s degree in Business Administration, Health Administration, Public Health, or Public Administration
- 10+ years in managed care, payer operations, or healthcare contracting
- 7+ years of progressive leadership experience
- Experience managing enterprise payer performance portfolios exceeding $1B in net revenue
- Experience leading payer dispute resolution and contract enforcement
- Experience working in capitated and HMO environments
- Membership in HFMA and/or ACHE
- Active in CHA and HASC managed care committees
Benefits:
- Comprehensive Benefits
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