Director, Market Access – Reimbursement Policy

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and implement thorough market access strategies that promote the growth and adoption of Agendia's precision oncology portfolio.

• Identify opportunities and risks related to reimbursement, payer policies, coding, and healthcare regulations.

• Provide insights to leadership regarding market access trends, competitive dynamics, and reimbursement developments.

• Assist in access planning for new products, evidence-generation initiatives, and commercial expansion efforts.

• Lead projects aimed at optimizing payer coverage, coding, and reimbursement outcomes.

• Evaluate payer medical policies, utilization management requirements, and reimbursement trends.

• Collaborate with Revenue Cycle Management and Commercial teams to overcome reimbursement obstacles and enhance payer performance.

• Support strategies related to coding, pricing, and payment, including CPT®, PLA, and CLFS initiatives.

• Analyze reimbursement data and payer performance to facilitate access improvements.

• Align evidence-generation priorities with the evidence requirements of payers.

• Convert clinical utility, analytical validity, and health economic evidence into compelling payer value propositions.

• Offer a market access perspective on publications, studies, presentations, and evidence-development strategies.

• Keep abreast of legislative, regulatory, and policy changes impacting precision oncology, molecular diagnostics, and personalized medicine.

• Establish and nurture relationships with commercial health plans, Medicare stakeholders, laboratory benefit managers, policy organizations, and professional societies.

• Represent Agendia in discussions with payers, advisory boards, industry meetings, and market access forums.

• Facilitate engagement with CMS, Medicare Administrative Contractors, and governmental stakeholders.

• Act as a subject matter expert on reimbursement, market access, and payer policies.

• Lead cross-functional projects that support market access goals and business growth.

• Provide insights that inform clinical, commercial, and corporate decision-making.

• Collaborate with Commercial teams on customer education concerning access, reimbursement, and payer policies.

• Encourage alignment among internal stakeholders.

• Report directly to the Sr. VP, Reimbursement & Government Affairs.

• Work cooperatively with all departments and take part in cross-functional projects, meetings, risk assessments, and audits.

⛳️ Requirements

• Bachelor's degree in Life Sciences, Healthcare Administration, Public Health, Health Policy, Business, or a related field.

• Over 8 years of progressive experience in market access, reimbursement, managed care, healthcare policy, health economics, or similar healthcare functions.

• Experience in molecular diagnostics, genomics, oncology, biotechnology, laboratory medicine, or precision medicine sectors.

• Strong knowledge of U.S. commercial and government reimbursement systems, coverage policy development, and payer decision-making processes.

• Proven ability to influence senior stakeholders and lead complex cross-functional initiatives.

• Exceptional strategic, analytical, communication, and presentation abilities.

• Experience supporting precision oncology, genomic testing, or personalized medicine products.

• Familiarity with Medicare, CMS, MolDx, commercial payers, and laboratory benefit managers.

• Background in health economics, outcomes research, evidence-generation strategy, or payer policy development.

• Candidates must not be classified as excluded individuals who are prohibited from participating in any Federal health care program.

• Willingness to travel up to 40% of the time.

🏝️ Benefits

• Fully remote work arrangement.

• Reasonable accommodations for individuals with disabilities.

• Ability to travel up to 40%.