Director, Managed Care

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🕒 April 10

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City of Hope

WebsiteLinkedInAll Job Openings

10,000+ employees

🧬 Biotechnology

🔬 Science

🤝 Non-profit

💰 $5.4M Grant - City of Hope on 2024-05

Biotechnology • Science • Non-profit

City of Hope is a nonprofit, NCI-designated comprehensive cancer center and research hospital near Los Angeles that provides patient care, conducts translational biomedical research, and offers education and clinical trials across a national network. It focuses on cancer, diabetes, and other life‑threatening diseases, combining clinical services, laboratory science, training and community outreach to develop new treatments and support patients and families.

📋 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. • 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.