Sr Manager​/AD, Market Access & Reimbursement

The Senior Manager / Associate Director of Market Access and Reimbursement will refine and execute on the commercial coverage strategy for diagnostics portfolio and secure coding and favorable coverage and payment from public and private payers. Activities will range from the tactical (e.g., credentialing) to the strategic (e.g., payor targeting to contracting). This role ensures the widest possible patient access to our technologies by proving their clinical and economic value.

• Refine coverage, coding, and payment strategies for existing and new products for both public and private payors.
• Secure unique CPT, PLA, or ICD-10 diagnostic codes as needed.
• Create and refine compelling, evidence-based payor value dossiers and other marketing materials for public and private payers.
• Align clinical trial endpoints to address payer evidence requirements, including cost effectiveness modeling and clinical utility studies.
• Work with Billing to analyze market and payor trends, broad policy changes, and other reimbursement dynamics (e.g., reimbursement landscape for competitive products).

• Build relationships with medical directors at regional and national commercial health plans, as well as at Medicare Administrative Contractors (MACs).
• Present clinical and economic data to secure positive coverage policies.
• Partner with health economics firms to build cost-effectiveness models.
• Work with Marketing to mobilize patient advocacy groups and clinicians to support coverage.

• Advise R&D and Clinical teams on clinical utility study design.
• Along with Billing and our reimbursement consultants, monitor changes among
• Work with Billing to train internal sales teams on billing and prior authorization processes.
• Coordinate with Sales leadership to inform team as to new coverage policies and contracting developments that are locally important to account executives and their key accounts.
• Ensure all market access activities meet healthcare compliance standards.

• Experience
  : 10+ years healthcare industry experience. 7+ years in reimbursement and market access, with a strong preference for diagnostics experience in the oncology field.
• Education
  :
  Bachelor's degree or advanced degree in related field.
• Domain Expertise
  :
  Prior success in market access across both LDT or IVD products. Deep understanding of HEOR, managed care, and health policies.
• Startup Agility
  :
  Proven ability to thrive in ambiguous environments.
• Other
  :
  Strong communication skills, demonstrated ability to work cross-functionally, and internal relationship-building.