Senior Manager, Payer Access and Reimbursement

Responsibilities

• Aid in the development of MA strategies aligned with business needs and the evolving external health system environment.
• Identify and harness opportunities to improve coverage and reimbursement (C/R) for assigned Payer Access category in all phases.
• Evaluate coverage landscape and focus on clinical utility.
• Leverage and coordinate internal/external stakeholders and resources to identify and address C/R opportunities.
• Collaborate with cross-functional teams to develop Payer Access strategies to optimally support business needs.
• Support efforts to develop medical value proposition for marketed tests and pipeline assets.
• Execute project responsibilities for some aspects of the evidence-based medical documentation development and communication.
• Identify and track progress of Annual Operating Plan (AOP) activities including appropriate metrics and reporting platforms.
• Participate in the drafting and revision of written materials for external distribution.
• Maintain knowledge of all assigned disease states, products, relevant changes in medical and reimbursement policies, and changes in payer procedures.
• Educate the Clinical Franchise, Commercial, Medical, Legal/Compliance, and Research and Development organizations about the evolving healthcare payor environment, the key external stakeholders, and their evidence needs.
• Lead and contribute to establishing processes that support successful development and communication of reimbursement-based value proposition for Quest Diagnostics offerings.
• Support and lead the strategic development and participation in health policy efforts.

Qualifications

• 8 years’ experience in laboratory medicine (e.g., Medical Technologist, cytotechnologist, microbiologist, molecular variant scientist, laboratory genetic counselor).
• 8 years’ experience in payer policy/claims procedures (e.g., medical/reimbursement policy, billing and coding).
• 10 years’ experience in laboratory medicine (evidence preferred).
• 10 years’ experience in payer policy/claims procedures (evidence preferred).
• 10 years’ experience in clinical practice (evidence preferred).

About the Role

This is a Remote opportunity.

Pay

Pay Range: $130,000 - $155,000/year, 15% Annual Incentive Plan/Bonus Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, certifications obtained. Market and organizational factors are also considered. Successful candidates may be eligible to receive annual performance bonus compensation.

Benefits

• Medical/Prescription Drugs
• Dental
• Vision
• Flexible Spending Accounts (FSAs)
• Supplemental Health Plans
• 401(k) Plan – Company match dollar-for-dollar up to 5%
• Employee Stock Purchase Plan (ESPP)
• Supplemental Life Insurance
• Dependent Life Insurance
• Short- and Long-Term Disability buy-up
• Blueprint for Wellness
• Emotional Well-Being Resources
• Education Assistance

Skills

• Strong time management
• Strong written and oral communication skills
• Collaborative approach in cross-functional team settings
• Intermediate-advanced skills in using Microsoft™ Word, Excel, and PowerPoint software packages

Requirements

• Ability to execute concurrent projects
• Adaptable to abrupt changes in projects based on external influences/internal business needs
• Strategic mindset