Director, Market Access – Reimbursement Policy

🔥 18 minutes ago

🇺🇸 United States – Remote

💵 $200k - $215k / year

⏰ Full Time

🔴 Lead

👔 Director

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Agendia

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2003

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Agendia is a healthcare company that specializes in genomic testing for breast cancer patients. Their MammaPrint and BluePrint tests provide actionable insights to guide treatment decisions, helping to determine the risk of recurrence and tailor therapies according to the unique genetic profile of the tumor. By aiding healthcare providers in optimizing treatment plans, Agendia aims to enhance patient outcomes and deliver personalized care throughout the breast cancer journey.

📋 Description

• 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

🎯 Requirements

• 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%

🏖️ Benefits

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

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