Head Of Market Access

Please use link to apply: https://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=3bd5c297-be43-4cb4-8308-01407875bfa2&ccId=19000101_000001&lang=en_US

Mission of the role:

The Head of Market Access reports to the Vice President of Commercial and is responsible for the development of the managed care access strategy. A track record of successful partnership with National and Regional US payers and/or contracting with IDNs/Health systems is critical. This role is critical to the company’s strategic growth initiative aimed at elevating its presence from regional to national levels by securing partnerships with national and regional payers. The Head of Market Access will be instrumental in transforming access to transplant and oncology testing services across the country, ensuring broader patient access and integration into healthcare systems.

Your day-to-day:

• Developing the Managed care access strategy and tactics for VitaGraft and DetermaIO.
• Leverage your contacts with insurance organizations and health systems to drive access.
• Work collaboratively with our Finance teams to ensure alignment with internal financial goals.
• Present clinical and HECON data to support coverage, identify data gaps, and partner with medical affairs/clinical development to develop evidence that supports coverage.
• Lead the strategic development and execution of national payer relations and Market Access initiatives, aiming to secure and expand coverage for our transplant and oncology product portfolio
• Act as the primary executive contact for national payer negotiations, establishing and fostering strong relationships with major insurance providers, Medicaid, and Medicare to achieve favorable coverage policies.
• Collaborate closely with the senior leadership team to align Market Access strategies with the company’s growth objectives, focusing on the inclusion of our genetic testing solutions in national payer plans.
• Drive cross-functional efforts with sales, marketing, and clinical teams to remove reimbursement barriers and support the adoption of our client's services in transplant and oncology markets.
• Leverage existing relationships and build new connections with key decision-makers within the national payer community, industry groups, and healthcare organizations to advocate for genetic testing's critical role in modern healthcare.
• Ensure compliance with all federal, state, and local regulations, as well as adherence to corporate policies in Market Access activities and communications.

What it takes to do this job:

• Extensive experience in the diagnostic testing market, ideally with complex molecular tests in oncology, and demonstrated track record in driving favorable reimbursement with commercial payers and health systems.
• Deep knowledge of Billing, Appeals, and Prior Authorization tactics for successful payment of claims.
• Extensive knowledge of the US healthcare reimbursement landscape, including Medicare and Medicaid policies.
• Established relationships with key stakeholders at regional and national insurance companies and/or health systems.
• Proven ability to develop strategic relationships with payers, healthcare providers, and industry organizations.
• 8+ years of managed care medical policy development and contracting within the Health Care Industry.
• Success in negotiating and contracting agreements.
• Travel up to 15%.

Who you are:

• You have a “do what it takes – no job is too small” team player and a positive attitude with a willingness to wear other hats and step in to perform and support other roles when needed.
• You have superb written and verbal skills and an exceptional ability to communicate clearly and professionally.
• Your organizational skills, attention to detail, and ability to multi-task are excellent.
• You like building effective internal and partner relationships including with team members, clients, vendors, suppliers, and team members.

You will have the opportunity to:

• Improve patient outcomes.
• Meaningfully impact the company’s short-term and long-term success.
• Work collaboratively across all levels within the organization.
• Grow your role as you see fit.
• Learn everything there is to know about cancer diagnostic laboratories.
• Create an inspiring workplace.

Job Type: Full-time

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift

Supplemental pay types:

• Bonus opportunities

Travel requirement:

• Up to 25% travel

Work Location: Remote