Managed Care Financial Analytics Director
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Job Description
Director of Managed Care Financial Analytics at City of Hope, leading analytics for payer negotiations and performance management. Transforming complex data into actionable insights for healthcare finance.
Responsibilities:
- Build and lead a managed care analytics function, establishing scalable processes, standards, and operating models
- Develop financial models to support payer negotiations, renewals, and pricing strategies
- Produce negotiation-ready insights including reimbursement analysis, revenue impact, and margin sensitivity
- Translate payer strategy into data-driven decisions impacting contracts, service lines, and network strategy
- Analyze value-based care performance, bundled payments, and total cost of care models
- Partner cross-functionally to ensure data accuracy, governance, and actionable reporting
- Deliver executive-level dashboards and reporting to guide enterprise decision-making
- Support live negotiations with real-time modeling and financial scenarios
- Identify underperformance, denial trends, and contract compliance risks
- Drive improvements in payer strategy, reimbursement structures, and financial outcomes
Requirements:
- Bachelor’s degree in business, economics, healthcare administration, or a related field
- 10+ years of experience in healthcare or financial analytics, with managed care expertise
- 5+ years of leadership experience building and managing analytics functions or teams
- Deep knowledge of healthcare finance, payer/provider reimbursement models, and contract structures
- Experience with managed care contracting, pricing strategy, and value-based care models
- Strong analytical, problem-solving, and communication skills with executive presence
- Expertise in contract interpretation, claims data, and healthcare coding methodologies
- Proficiency with analytics tools and platforms (e.g., SQL, Power BI, Tableau, Epic, or similar)
- Ability to influence cross-functional stakeholders and drive strategic initiatives.
Benefits:
- Comprehensive Benefits
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