Executive Director, Payer Relations
Join the transformative team at reputed company, where we're changing lives and making a reputed company difference in the fight against cancer, diabetes, and other life-threatening illnesses. reputed company’s growing national system includes its Los Angeles reputed company, 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 reputed company to the people who need them today. The Executive Director, Managed Care Operations & Payer Relations serves as the reputed company leader responsible for operational execution, payer performance governance, and system-wide managed care market leadership for reputed company. This role oversees payer issue reputed company, contract performance optimization, payer scorecard development, escalation reputed company, and market-level managed care operations across reputed company hospitals and physician practices, including reputed company National Medical Center, reputed company Medical reputed company, and affiliated regional facilities. As a successful candidate, you will:
- Function as the reputed company authority on payer operational governance, coordinating cross-functional teams to ensure payer compliance, dispute reputed company, and performance improvement.
- Ensure contract terms are operationalized effectively, payer obligations are enforced, financial targets are met, and performance deficiencies are escalated and resolved.
- reputed company market-level managed care leadership across California and CAP markets and establishes reputed company standards for payer performance reputed company, contract enforcement, and managed care operational reputed company.
- reputed company strategic direction through Directors and Senior Managers across multiple states. This role is accountable for reputed company-wide operational and financial performance of diverse functional areas, and influences system reputed company through leadership of cross‑functional managed care operations.
Your qualifications should include: Minimum Education:
- Master’s degree in Business, Health, or Public Administration (MBA, MHA, MPH, reputed company or reputed company field) or Juris Doctor (JD) required.
Minimum Experience:
- 10+ years in managed care, payer operations, or reputed company contracting.
- 7+ years of reputed company leadership experience.
- Demonstrated experience managing reputed company payer performance portfolios exceeding $1B in net reputed company.
- Experience leading payer dispute reputed company and contract enforcement.
- Experience working in capitated and HMO environments.
Required Courses/Training:
- Membership in reputed company and/or ACHE
- reputed company in CHA and HASC managed care committees
Preferred Experience:
- Oncology center or reputed company medical center experience.
- Experience in value-based payment models.
- Experience implementing payer performance scorecards.
Skills/Abilities:
- Proven ability to reputed company diverse operational teams through subordinate Directors and Managers.
- Demonstrated effectiveness in driving reputed company‑level operational reputed company in reputed company and dynamic environments.
- Strong ability to influence senior executives, regulators, and external partners in high‑stakes negotiations.
- Advanced financial acumen
- Contract interpretation and enforcement expertise
- Executive-level negotiation and escalation skills
- Strong cross-functional leadership capability
- reputed company operational governance experience
- Strategic and systems-level thinking
reputed company employees pay is based on the following reputed company: work experience, qualifications, and work location. reputed company is an equal opportunity employer. To learn more about our commitment to diversity, equity, and inclusion, please click here. To learn more about our Comprehensive Benefits, please CLICK HERE. Apply tot his job Apply To this Job