Senior Director, Health Policy & Reimbursement

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🔥 47 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

👔 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

• Monitor federal and state legislative, regulatory, coding, payment, and coverage developments affecting clinical laboratories, molecular diagnostics, genomics, rare disease, and precision medicine • Translate policy changes into enterprise implications and action plans • Represent Baylor Genetics in health policy matters with trade associations, standards-setting organizations, public agencies, coalitions, payer policy forums, and other external stakeholders • Lead end-to-end coding strategy for products, including CPT applications through the American Medical Association and ICD-10-CM proposals through the CDC and other federal processes • Develop evidence, utilization, clinical-workflow, and economic rationales supporting coding, valuation, coverage, and reimbursement submissions • Lead state health policy strategies to accelerate adoption and sustainable funding of rapid WGS for critically ill infants and children • Partner with Government Affairs, external coalitions, and registered lobbyists to engage state legislatures and members of Congress • Lead reimbursement planning for new products, platform extensions, and tuck-in acquisitions • Integrate reimbursement and policy diligence into business-development evaluations • Guide responses to proposed rules, payer policies, fee schedules, laboratory payment reforms, and public-comment opportunities • Build policy briefs, scenario analyses, risk assessments, and recommendations for senior leadership and the Board • Partner with Revenue Cycle and Finance to assess payment adequacy, coding performance, denials, fee-schedule changes, and financial impact • Maintain governance, documentation, and compliance controls for policy engagement, coding submissions, coalition activity, and external representation • Lead, coach, develop, and retain a team responsible for health policy, coding, reimbursement strategy, and government-affairs coordination • Establish objectives, operating rhythms, decision rights, and accountability aligned with enterprise priorities • Conduct portfolio, policy, and pipeline reviews; remove barriers and ensure timely execution • Develop succession plans and organizational capability in laboratory policy, coding, payment, and state-government engagement • Promote integrity, evidence-based advocacy, cross-functional partnership, and execution excellence • Deliver federal and state health policy strategies, coding roadmaps, rWGS adoption strategies, policy engagement plans, reimbursement-readiness assessments, and executive dashboards

🎯 Requirements

• Bachelor’s degree in Health Policy, Public Health, Life Sciences, Business, Healthcare Administration, Health Economics, or a related field • 7+ years of leading teams in health policy and reimbursement • 12+ years of progressive experience in combination with the specified experience • 8+ years of progressive experience in health policy, reimbursement, coding, government affairs, market access, or related healthcare leadership roles • 8+ years of direct laboratory health policy and reimbursement experience, preferably in molecular diagnostics, genomics, or precision medicine • Demonstrated experience leading CPT coding strategy and familiarity with ICD-10-CM coordination and federal coding processes • Demonstrated success influencing state or federal health policy, reimbursement, Medicaid, or legislative initiatives through compliant advocacy and coalition engagement • Experience leading and developing teams responsible for policy, coding, reimbursement, or government affairs • Ability to interpret legislation, regulations, coding guidance, payment policy, and payer requirements and translate them into business strategy • Executive-level communication, deductive storytelling, negotiation, and cross-functional influence skills • Ability and willingness to travel approximately 40–50% domestically • Preferred: MBA, MPH, MHA, JD, MS, PharmD, PhD, or equivalent advanced degree • Preferred experience with rWGS, WGS, WES, NGS, rare disease, oncology genomics, reproductive genetics, or pediatric critical care • Preferred experience with AMA CPT processes, CMS payment systems, state Medicaid programs, and CDC ICD-10-CM coordination processes • Preferred established relationships with laboratory trade associations, patient-advocacy organizations, state policy coalitions, federal agencies, and legislative stakeholders • Preferred experience supporting product pipeline strategy, licensing, mergers and acquisitions, or post-acquisition integration • Preferred experience developing public-comment letters, legislative language, fiscal-impact analyses, or reimbursement evidence packages

🏖️ Benefits

• Equal opportunity employer committed to an inclusive and diverse workplace • Reasonable accommodation during the application process • Remote work arrangement

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