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DIRECTOR, MANAGED CARE - 10034394

Anywhere, USA

City of Hope is an independent biomedical research and treatment center for cancer, diabetes and other life-threatening diseases. 

Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution. AccessHope™, a wholly owned subsidiary, was launched in 2019 and is dedicated to serving employers and their health care partners by providing access to City of Hope’s exceptional cancer expertise. 

A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s “Best Hospitals” in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.


Pay Rate: $92.4 - $154.31 per hour

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. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today. 

The Director, Managed Care will plan and execute managed care contracting activities and develop payer strategy to promote patient access, in order to achieve annual budgeted net patient revenue goals of City of Hope National Medical Center and City of Hope Medical Foundation.  This role serves as the managed care leader for managed care operations, and payor expert supporting City of Hope’s clinical sites and City of Hope’s community growth and expansion. 

As a successful candidate, you will: 

  • 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

Your qualifications should include: 

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

City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.

City of Hope is an equal opportunity employer.

To learn more about our Comprehensive Benefits, pleaseCLICK HERE.

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