Senior Manager / Associate Director, Market Access & Reimbursement

Key Responsibilities & Duties

• Refine coverage, coding, and payment strategies for existing and new products for both public and private payors.
• 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.
• Analyze market and payor trends, broad policy changes, and other reimbursement dynamics (e.g., reimbursement landscape for competitive products).

Payer Engagement & Advocacy

• 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.
• Mobilize patient advocacy groups and clinicians to support coverage.

Cross-Functional Support & Compliance

• Advise CDx R&D and Clinical teams on clinical utility study design.
• Monitor changes among CDx Billing and our reimbursement consultants.
• Train internal sales teams on billing and prior authorization processes.
• Inform CDx Sales leadership about new coverage policies and contracting developments that are locally important to CDx account executives and their key accounts.
• Ensure all market access activities meet healthcare compliance standards.

Required Qualifications

• 10+ years healthcare industry experience.
• 7+ years in reimbursement and market access, with a strong preference for diagnostics experience in the oncology field.
• Bachelor’s degree or advanced degree in related field.
• Deep understanding of HEOR, managed care, and health policies.
• Proven ability to thrive in ambiguous environments.

Preferred Qualifications

• Advanced degree such as MBA.
• Experience with advanced diagnostics, point-of-care, or oncology tools.