Note: The job is a remote job and is open to candidates in USA. City of Hope is a transformative organization dedicated to changing lives in the fight against cancer and other illnesses. The Managed Care Financial Analytics Director is responsible for leading analytics capabilities that support payer negotiations and reimbursement strategies, transforming complex data into actionable insights to influence revenue performance.
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
Skills
- 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
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