Managed Care Financial Analytics Director

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🕒 June 17

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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

• 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