Director of Market Access Operations

Millennium Health LLC is an accredited specialty laboratory with more than a decade of experience in medication monitoring and drug testing services, helping clinicians monitor the use and misuse of prescription medications and illicit drugs. The testing is used by healthcare professionals to obtain objective information about patients' recent use of prescription medications and/or illicit drugs and helps monitor the effectiveness of treatment plans.

GENERAL SUMMARY

The Director of Market Access Operations is responsible for participating in the management of company's goals for contractual relationships and financial achievements with payers (insurers, managed care organizations, medical groups, federal, state, and local governmental entities, and other third-party payer-related entities). The role will analyze and assess existing and prospective payer relationships, needs, and development to support evidence-based decision-making and optimal revenue improvement and growth.

ESSENTIAL FUNCTIONS

The following are intended to be examples of the accountabilities for which the person in this position is responsible. This position description is not intended to be complete or all-inclusive and does not preclude management from assigning other or related functions for which the individual has demonstrated competency through performance.

* Monitor contract performance process to quantify the profitability of Managed Care programs and help develop strategies and tactics for remediation of underperforming contracts working directly with the Senior Director of Market Access

* Work with contracted insurers, sales leadership, and marketing to manage and implement successful redirection and other collaborative pull-through-related programs

* Willingness to participate in basic management needs of the department (e.g., state payer lists, redirection curation, contract reviews, etc.)

* Support development of strategy and prioritization for managed care contracting in collaboration with the Senior Director and the Senior Vice President of Market Access

* Assist the contract development process from insurer contract proposals through final approval, including deal structure, analysis, forecasting, and reporting of contract profitability

* Establish collaborative working relationship with sales leadership and their teams to inform and guide market access strategies, key target identification, and optimal opportunities for synergistic value creation

* Analysis and support of contracted in-network reimbursement rates for Millennium Health, and identify and pursue opportunities to improve rates that are below market

* Collaborate closely with Millennium Health functional leadership, contracting Consultants, finance team, billing department, analytics executives, legal counsel, and key customers

* Manage existing insurer contracts to ensure continuity, successful renewal, and renegotiate fee schedules where appropriate to achieve revenue optimization.

* Capable of supporting the Market Access team through engagement in policy and advocacy-related work (e.g., ACLA, CCLA, CAHP, MGMA)

* Capability in conducting basic financial analyses to inform strategies and prioritization

* Develop internal and external partnerships to enable funding, reimbursement, and access, which can include guidelines, innovative financing or payment models, and public health programs

* Partner with all cross-functional stakeholders to align on priorities and resourcing for business objectives across all areas of the enterprise

* Ability to think strategically regarding the value of Market Access for Millennium and advancement and advocacy of the purpose and value of drug testing itself

* Ability to ensure HIPAA, Confidentiality, and Compliance policies, procedures, and standards are always adhered to.

* Ability to ensure administrative, physical, and technical cyber security controls are always adhered to.

* Regular and reliable attendance

SECONDARY

ACCOUNTABILITIES

Remains aware of evolving needs and opportunities, showing flexibility in doing whatever is appropriate to support the Company's success. Pursues educational opportunities to maintain advanced and up-to-date knowledge in the field. Performs all other related duties as required and assigned and understands that the items in this description are not all-inclusive.