Executive Director, Payer Relations

City of Hope

2d

About The Position

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 Executive Director, Managed Care Operations & Payer Relations serves as the enterprise leader responsible for operational execution, payer performance governance, and system-wide managed care market leadership for City of Hope. This role oversees payer issue resolution, contract performance optimization, payer scorecard development, escalation strategy, and market-level managed care operations across all hospitals and physician practices, including City of Hope National Medical Center, City of Hope Medical Foundation, and affiliated regional facilities.
As a successful candidate, you will:
Function as the enterprise authority on payer operational governance, coordinating cross-functional teams to ensure payer compliance, dispute resolution, and performance improvement.
Ensure contract terms are operationalized effectively, payer obligations are enforced, financial targets are met, and performance deficiencies are escalated and resolved.
Lead market-level managed care leadership across California and CAP markets and establishes enterprise standards for payer performance oversight, contract enforcement, and managed care operational excellence.
Provide strategic direction through Directors and Senior Managers across multiple states. This role is accountable for enterprise-wide operational and financial performance of diverse functional areas, and influences system strategy through leadership of cross‑functional managed care operations.

Requirements

• Master’s degree in Business Administration, Health Administration, Public Health, or Public Administration
• 10+ years in managed care, payer operations, or healthcare contracting.
• 7+ years of progressive leadership experience.
• Demonstrated experience managing enterprise payer performance portfolios exceeding $1B in net revenue.
• Experience leading payer dispute resolution and contract enforcement.
• Experience working in capitated and HMO environments.
• Membership in HFMA and/or ACHE
• Active in CHA and HASC managed care committees
• Proven ability to lead diverse operational teams through subordinate Directors and Managers.
• Demonstrated effectiveness in driving enterprise‑level operational strategy in complex 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
• Enterprise operational governance experience
• Strategic and systems-level thinking

Nice To Haves

• Oncology center or academic medical center experience.
• Experience in value-based payment models.
• Experience implementing payer performance scorecards.

Responsibilities

• Function as the enterprise authority on payer operational governance, coordinating cross-functional teams to ensure payer compliance, dispute resolution, and performance improvement.
• Ensure contract terms are operationalized effectively, payer obligations are enforced, financial targets are met, and performance deficiencies are escalated and resolved.
• Lead market-level managed care leadership across California and CAP markets and establishes enterprise standards for payer performance oversight, contract enforcement, and managed care operational excellence.
• Provide strategic direction through Directors and Senior Managers across multiple states. This role is accountable for enterprise-wide operational and financial performance of diverse functional areas, and influences system strategy through leadership of cross‑functional managed care operations.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Number of Employees: 1,001-5,000 employees