Market Access Specialist

What You Can Expect

• Conducts analytical work to support Market Access strategies and payer submissions.
• Supports the development and execution of payer strategies through data analysis, monitoring payer trends, and assisting with escalated case resolution, bridging operational execution and strategic insight.

How You'll Create Impact

• Analyses payer and reimbursement data to identify market trends and insights.
• Develops materials supporting payer engagement and reimbursement submissions.
• Collaborates with cross-functional teams on access and pricing projects.
• Drafts summaries and reports communicating key findings to stakeholders.
• Maintains current knowledge of payer policy and formulary updates.
• Affords assistance in preparing business cases and evidence packages for payer negotiations.
• Ensures compliance with internal processes and regulatory requirements.
• Contributes to the refinement of tools, models, and templates for market access analyses.
• Maintains claims data and identifies situations where CD Laboratories may want to contract with third-party payers.
• Maintains claims data and identifies negative payer coverage and claims processing issues, identifying methods of resolution and needed advocacy.
• Affords assistance in payer contract negotiations, providing recommendations for appropriate contract terms and fee schedule allowances.
• Affords oversight of CD Laboratories claims processing, ensuring efficient and compliant claims processes.
• Leads resolution process for payer coverage and denial issues.

Education and Experience

• Bachelor's Degree and 2 years of relevant experience, or Associate's Degree and 4 years of relevant experience, or High School Diploma or Equivalent and 6 years of relevant experience.
• Bachelor’s degree in healthcare administration, health insurance, nursing or related field is preferred.
• 2 years of experience in market access, reimbursement, payer relations, or healthcare analytics is preferred.

Travel Expectations

• Up to 10%

EEO/M/F/Vet/Disability

• Expected Compensation Range: $79,293 to $100k, plus target bonus