Senior Director, Reimbursement – Oncology

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $228k - $313.5k / year

⏰ Full Time

🟠 Senior

👔 Director

🦅 H1B Visa Sponsor

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Guardant Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

🏥 Healthcare

💼 Consulting

🍽️ Food & Beverage

Healthcare • Consulting • Food & Beverage

Guardant Health is a precision oncology company that specializes in using blood tests to revolutionize cancer care. Their innovative tests provide critical insights that help inform treatment decisions for patients across all stages of cancer. By leveraging advanced technology and data, Guardant Health aims to improve clinical outcomes and enhance the overall patient experience in the fight against cancer.

📋 Description

• Act as company subject matter expert in billing and payment strategy, focusing on optimizing revenue cycle management and maximizing reimbursement • Manage a team responsible for approval and correct processing of patient claims with high customer satisfaction • Oversee the design and build of a Patient Financial Assistance Program • Develop internal metrics and optimization strategies for reimbursement data and history • Partner with internal and external software developers to enable automated workflows and process efficiency for revenue cycle management • Oversee strategy and development of scalable internal operational policies and SOPs • Build and sustain partnerships with payers and providers • Ensure contracts are loaded and claims adjudication is managed consistently with contractual and regulatory language • Collaborate with internal and external stakeholders to resolve patient billing and provider issues • Manage and support billing operations and administration for efficient, effective, and compliant revenue cycle management • Interface with finance on FP&A, SOX, and determination of ASP for products • Provide reimbursement guidance for commercialization of new tests

🎯 Requirements

• 15+ years total experience • 5+ years of professional experience in Reimbursement and Billing in a life sciences or payer setting • 5+ years of management experience with a billing team • Bachelor’s degree required • Graduate degree in a related field such as public health or public policy preferred • Open to travel up to 15% • Experience working with payers as a laboratory that bills molecular tests • Knowledge of federal and state legislative environments and regulatory processes • Expertise in medical billing, third-party payers, patient interface, privacy, and confidentiality • Knowledge of SOP development in a HIPAA-compliant environment and molecular billing codes and regulations • Experience in people management and vendor management • Strong analysis skills and ability to interface with a variety of software tools • Excel skills mandatory • SQL or other databasing skills desirable • Program management and systems engineering skills a significant plus • AI or PowerAutomate experience a significant plus • Curiosity, sound judgment, and ability to critically evaluate and responsibly leverage AI-enabled tools in accordance with company policies, ethical standards, and regulatory requirements • Background screening including criminal history required

🏖️ Benefits

• Hybrid work model with work-from-home days for eligible onsite employees • Flexible work-life balance through scheduled in-office and focused work-from-home days • Reasonable accommodations for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs