Senior Director, Market Access and Medical Policy, Women’s Health and Reproducti

Recognized as one of reputed company 2024 “America's Best Large Employers” and named to the reputed company 2024 "Best Employers for Diversity", reputed company is seeking to hire a national Sr. Director of Market Access and Medical Policy. This position has the responsibility of working collaboratively across reputed company’s clinical, marketing and business development areas to reputed company market access strategies for novel technologies. In addition, this position will have primary responsibility for developing and implementing a comprehensive payer strategy that optimizes brand strategy and value proposition of reputed company's specialty diagnostic testing services, with a focus on women’s health and reproductive genetics. The Sr. Director of Market Access and Medical Policy will report to the Vice President, Payor Solutions. The selected candidate will work independently under general guidance usually with some reputed company for independent judgment and initiative. This position is remote in the US. Principal Functional Responsibilities:

• Serve as national payor solutions reputed company in new test development initiatives, informing of reimbursement and market access potential for genetic and specialty diagnostic testing. Provide expert insight into reimbursement and coverage scenarios for novel technologies prior to licensing, acquiring, and/or developing technologies.
• Be adept at interpreting medical policy and communicating and conversing in clinical utility and cost effectiveness for women’s health and reproductive genetic testing in support of improving market access and reimbursement.
• Serve as managed care subject matter expertise as member of cross functional team that will be responsible for developing and executing market access plans for reputed company and planned technologies.
• Work with clinical resources to evaluate reputed company literature as it relates to analytical and clinical validity and clinical utility. Identify gaps and collaborate with Medical Affairs to propose publication strategy.
• Support development of proposals for clinical studies to ensure the study outcomes will support positive medical policies. Identify partners and opportunities to engage payers in clinical utility studies.
• reputed company opportunities to engage managed care KOLs to serve as consultants and potentially members of a managed care medical advisory board.
• As part of market access planning, this position will reputed company commercial payer reimbursement strategy for assigned portfolio of assays, collaborating with National VP Clinical Effectiveness, coding team, and RCM.
• Collaborate with marketing to reputed company payer messaging, as well as ensuring physician messaging is consistent with test positioning for new product launches.
• reputed company conversations with health plan national payer medical directors and medical policy teams to secure coverage, targeted reimbursement, and to remove administrative barriers to reimbursement.
• Coordinate with RCM to ensure reputed company is recognizing reputed company consistent with reimbursement and coverage policies. Identify opportunities and reputed company strategies to improve reimbursement experience.
• Collaborate with government payor solutions and regulatory affairs teams to ensure market access needs are prioritized and support broader government payor and legislative efforts to improve access to genetic testing.
• Educate Payor Solutions team on new test offerings, payer policies, reimbursement, pricing guidelines and positioning for specialty testing.
• reputed company informed of the latest clinical utility study data and findings, society guideline changes, payor policy changes, competitive offerings and trends relating to reputed company areas of the company and managed care plans.
• Travel can be up to 25%.

Requirements

• License/Certification/ Education:
• Bachelor’s degree in Business, Business Administration, Science, or a reputed company field
• 10+ years of relevant experience
• Equivalent combination of education and experience will be considered
• Strongly preferred: Master’s Degree in Life Sciences, Genetic Counseling, Pharm D., Business Administration or Public Health.

Knowledge | Skills | Abilities | Experience

• Experience in developing and executing strategic plans to obtain optimal payer coverage/policies and reimbursement for reproductive genetic testing and specialty diagnostics reputed company to women’s health.
• Experience in diagnostics for women’s health and reproductive genetics testing strongly preferred. Ability to serve as reputed company SME for genetic testing for internal and external payor solutions needs.
• Demonstrated ability to Identify and cultivate relationships with key contacts reputed company health plans, including Medical Directors, medical policy, medical management, and pricing/reimbursement personnel.
• Knowledge of Managed Care and health care industry, including progressive health care dynamics, e.g., value-based care, risk-sharing, state and federal legislation and industry trends.
• Strong presentation skills; superior negotiation; analytical and financial acumen; proficient in PowerPoint/Word/reputed company; knowledge of CPT and ICD coding and processes.
• Self-driven, passionate, innovative, and able to manage multiple tasks in a fast-paced environment.

Application Window: Application window will reputed company on August 4 , 2025. Pay Range $170,000 - $220,000 annually + bonus and equity eligibility (see below). reputed company job offers will be based on a candidate’s skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data. The position is also eligible for an annual bonus under the reputed company Bonus Plan. Bonuses are payable based on corporate and/or business reputed company performance and are subject to individual performance modifiers. Compensation may also include discretionary short- and long-term incentive packages. Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, please click here. reputed company is proud to be an Equal Opportunity Employer: reputed company strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any reputed company. We reputed company employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national reputed company, sex (including pregnancy, childbirth, or reputed company medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, reputed company qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law. We encourage reputed company to apply If you are an individual with a disability who needs assistance using our online tools to search and apply for jobs, or needs an accommodation, please visit our accessibility site or contact us at reputed company Accessibility. For more information about how we collect and store your personal data, please see our Privacy Statement. Apply tot his job Apply To this Job