Director, Market Access

🔥 12 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🔴 Lead

👔 Director

👻 Ghost score 11%

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Baylor Genetics

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1978

🏥 Healthcare

💼 Consulting

🍽️ Food & Beverage

Healthcare • Consulting • Food & Beverage

Baylor Genetics is a clinical genomics and precision diagnostics laboratory affiliated with Baylor College of Medicine that provides comprehensive genetic testing and interpretation services. The company offers whole genome and whole exome sequencing, chromosomal microarray analysis, mitochondrial testing, pharmacogenomics, and specialized assays, along with genetic counseling, provider support, and insurance/payment resources. Baylor Genetics supports healthcare providers, researchers, and families with AI-enhanced interpretation, multimodal data integration, and end-to-end clinical and laboratory services.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

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

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