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Associate Director Market Access Reimbursement - Reproductive/Women's Health
Ref No.: 21-00014
Location: Northeastern USA Territory
Responsibilities:
  • Identify and cultivate relationships with key contacts within health plans, including Medical Directors, medical policy, medical management and pricing/reimbursement personnel.
  • Be adept at both communicating and conversing in clinical utility and cost effectiveness for specialty tests in support of improving market access and reimbursement.
  • Analyze reimbursement data in conjunction with medical policies to identify and prioritize opportunities to improve reimbursement experience of focus tests.
  • Improve reimbursement experience by improving coverage/medical policies and reducing administrative requirements for reimbursement.
  • Serve as national specialty managed care lead in new test development initiatives, informing of reimbursement and market access potential for reproductive genetic tests.
  • Educate Managed Care Executive team on new test offerings, on payer policies and reimbursement, and pricing guidelines and positioning for specialty testing.
  • Review andsupport the responsesto proposals and contracts as it relates to focus tests and new technology. In collaboration with the Managed Care team, support efforts to negotiate and secure target pricing for targeted tests.

Requirements
  • Normally B.S. Degree required w/5+ years of experience. Preferred degree(s): Business; Business Administration, Science or related degreeStrongly preferred:Master's Degree in Life Sciences, Business Administration or Public Health.
  • Ideally located in the Northeastern region of the United States to manage respective territory
  • Experience in developing and executing strategic plans to obtain optimal payer coverage/policies and reimbursement for key esoteric tests.
  • Demonstrated ability to Identify and cultivate relationships with key contacts within health plans, including Medical Directors, medical policy, medical management and pricing/reimbursement personnel.
  • Knowledgeof Managed Care and health care industry, including progressive health care dynamics; e.g. value based care and risk-sharing, and industry trends.
  • Strong presentation skills; superior negotiation; analytical and financial acumen; proficient in PowerPoint/Word/Excel; knowledge of CPT and ICD coding and processes.
  • Ability to serve as internal SME for managed care team for genetic, pathology, and esoteric testing; experience in reproductive genetic testing strongly preferred
  • Self-driven, passionate, innovative and able to manage multiple tasks in a fast paced environment.