Director, Market Access

🔥 10 horas atrás

🇺🇸 Estados Unidos – Remoto (EUA)

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

👻 Score fantasma 11%

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• Sem salário divulgado.

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Baylor Genetics

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 1978

🏥 Saúde

💼 Consultoria

🍽️ Alimentos e Bebidas

Healthcare • Consulting • Food & Beverage

A Baylor Genetics é um laboratório de genômica clínica e diagnóstico de precisão afiliado ao Baylor College of Medicine, que oferece serviços abrangentes de teste genético e interpretação. A empresa oferece sequenciamento do genoma completo e do exoma completo, análise cromossômica por microarray, testes mitocondriais, farmacogenômica e ensaios especializados, juntamente com aconselhamento genético, suporte para prestadores de serviços e recursos de seguro/pagamento. A Baylor Genetics apoia prestadores de saúde, pesquisadores e famílias com interpretação aprimorada por IA, integração de dados multimodais e serviços clínicos e laboratoriais de ponta a ponta.

Descrição

• Develop and execute strategic payer account plans expanding coverage, contracting, and reimbursement for Baylor Genetics testing, with emphasis on WGS-first policies • Establish value-based partnerships with commercial health plans, Medicare Advantage organizations, Medicaid and Managed Medicaid plans, integrated delivery networks, and other risk-bearing entities • Lead payer negotiations for coverage policies, fee schedules, network agreements, value-based arrangements, and administrative pathways • Create payer-specific value propositions connecting WGS-first testing to improved diagnostic yield, earlier clinical decision-making, reduced serial testing, fewer avoidable procedures, and lower total cost of care • Partner with HEOR, Medical Affairs, Clinical Affairs, Product, Finance, Revenue Cycle, and Commercial teams on evidence strategies, budget-impact models, cost-offset analyses, real-world evidence, and payer-facing value dossiers • Lead payer initiatives, pilots, and evidence-development partnerships measuring health outcomes, utilization impact, patient journey improvements, and cost savings • Secure positive medical policies and reduce prior authorization, documentation, coding, and reimbursement barriers • Monitor payer policy, reimbursement, competitive, and regulatory trends and provide account strategies and executive recommendations • Maintain account plans, opportunity forecasts, contracting milestones, risks, decisions, and next steps in business systems • Represent Baylor Genetics at payer medical-policy reviews, value-evidence meetings, industry forums, and executive discussions • Deliver payer partnership strategies, prioritized account plans, coverage-policy submissions, contracting proposals, value dossiers, budget-impact materials, payer pilots, evidence-generation initiatives, and executive reporting

🎯 Requisitos

• Bachelor’s degree in Life Sciences, Business, Healthcare Administration, Public Health, Health Economics, or a related field • 14+ years of progressive experience in market access, payer strategy, reimbursement, managed care contracting, HEOR, or molecular diagnostics • Demonstrated success securing payer coverage, negotiating contracts, improving reimbursement, or building value-based payer partnerships • Working knowledge of commercial, Medicare, Medicaid, and Managed Medicaid coverage and reimbursement pathways • Ability to interpret and communicate clinical utility, health-economic, real-world evidence, budget-impact, and total-cost-of-care analyses to payer audiences • Executive-level communication, negotiation, deductive storytelling, and cross-functional influence skills • Ability and willingness to travel approximately 40% domestically • MBA, MPH, MHA, MS, PharmD, PhD, or equivalent advanced degree preferred • Experience in genomics, molecular diagnostics, rare disease, oncology, reproductive genetics, women’s health, WGS, or WES preferred • Established relationships with national and regional health plans, payer medical directors, policy teams, and contracting leaders preferred • Experience designing or executing HEOR studies, budget-impact models, real-world evidence programs, value dossiers, or payer pilots preferred • Experience advancing WGS-first or comprehensive genomic testing coverage strategies preferred

🏖️ Benefícios

• Equal opportunity employer committed to fostering an inclusive and diverse workplace • Application process accommodations available through Human Resources

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