Director, Market Access – Reimbursement Policy

🕒 6 dias atrás

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $200.000 - $215.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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Agendia

SiteLinkedInTodas as Vagas

51 - 200 funcionários

Fundada em 2003

🏥 Saúde

💼 Consultoria

⚕️ Seguro de Saúde

Healthcare • Consulting • Healthcare Insurance

A Agendia é uma empresa de saúde especializada em testes genômicos para pacientes com câncer de mama. Seus testes MammaPrint e BluePrint oferecem insights acionáveis para orientar decisões de tratamento, ajudando a determinar o risco de recidiva e a personalizar terapias de acordo com o perfil genético único do tumor. Ao auxiliar os profissionais de saúde na otimização dos planos de tratamento, a Agendia visa melhorar os resultados dos pacientes e oferecer cuidados personalizados ao longo da jornada do câncer de mama.

Descrição

• Develop and execute comprehensive market access strategies supporting growth and adoption of Agendia's precision oncology portfolio • Identify reimbursement, payer policy, coding, and healthcare regulation opportunities and risks • Advise leadership on market access trends, competitive dynamics, and reimbursement developments • Support access planning for new products, evidence-generation initiatives, and commercial expansion • Lead initiatives to optimize payer coverage, coding, and reimbursement outcomes • Assess payer medical policies, utilization management requirements, and reimbursement trends • Partner with Revenue Cycle Management and Commercial teams to address reimbursement barriers and improve payer performance • Support coding, pricing, and payment strategies, including CPT®, PLA, and CLFS-related initiatives • Evaluate reimbursement data and payer performance to drive access improvements • Align evidence-generation priorities with payer evidence requirements • Translate clinical utility, analytical validity, and health economic evidence into payer value propositions • Provide market access perspective on publications, studies, presentations, and evidence-development strategies • Monitor legislative, regulatory, and policy developments affecting precision oncology, molecular diagnostics, and personalized medicine • Build and maintain relationships with commercial health plans, Medicare stakeholders, laboratory benefit managers, policy organizations, and professional societies • Represent Agendia in payer discussions, advisory boards, industry meetings, and market access forums • Support engagement with CMS, Medicare Administrative Contractors, and governmental stakeholders • Serve as a subject matter expert on reimbursement, market access, and payer policy • Lead cross-functional initiatives supporting market access objectives and business growth • Deliver insights informing clinical, commercial, and corporate decision-making • Partner with Commercial teams on customer education related to access, reimbursement, and payer policy • Foster alignment across internal stakeholders • Report to the Sr. VP, Reimbursement & Government Affairs • Cooperate with all departments and participate in cross-functional projects, meetings, risk assessments, and audits

🎯 Requisitos

• Bachelor's degree in Life Sciences, Healthcare Administration, Public Health, Health Policy, Business, or a related discipline • 8+ years of progressive experience in market access, reimbursement, managed care, healthcare policy, health economics, or related healthcare functions • Experience within molecular diagnostics, genomics, oncology, biotechnology, laboratory medicine, or precision medicine • Strong understanding of U.S. commercial and government reimbursement systems, coverage policy development, and payer decision-making processes • Demonstrated ability to influence senior stakeholders and lead complex cross-functional initiatives • Exceptional strategic, analytical, communication, and presentation skills • Experience supporting precision oncology, genomic testing, or personalized medicine products • Familiarity with Medicare, CMS, MolDx, commercial payers, and laboratory benefit managers • Experience in health economics, outcomes research, evidence-generation strategy, or payer policy development • Employees must not be classified as an excluded individual who is prohibited from participation in any Federal health care program • Ability to travel up to 40%

🏖️ Benefícios

• Fully remote work arrangement • Reasonable accommodations for individuals with disabilities • Ability to travel up to 40%

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