Director, Market Access – CMS Coverage & Reimbursement Policy

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🔥 0 minutes ago

🏛️ District of Columbia, Washington – Remote

🏛️ District of Columbia – Remote ☕ Washington – Remote

💵 $187.4k - $281k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Illumina

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1998

🏥 Healthcare

💼 Consulting

🏭 Manufacturing

💰 $750M Post-IPO Debt on 2023-01

Healthcare • Consulting • Manufacturing

Illumina is a leading company in the genomics field, providing innovative technologies for the analysis of genetic variation and function. They offer a wide range of products and services, including sequencing platforms, microarray technology, library preparation kits, bioinformatics software, and comprehensive genomic solutions. Illumina's next-generation sequencing platforms are used for various research and clinical applications, such as cancer research, reproductive health, and genetic disease detection. The company is dedicated to improving human health by enabling researchers and clinicians to accelerate their genomic discoveries and applications, ultimately impacting precision medicine and life sciences globally.

📋 Description

• Lead Medicare market access strategies for genomic sequencing and genetic testing • Develop strategies for NCDs, LCDs, MolDx, MAC engagement, CLFS pricing, CPT/PLA coding, and reimbursement • Monitor CMS rulemaking and federal reimbursement policy developments • Partner with Government Affairs on federal advocacy and policy initiatives • Collaborate with Medical Affairs and HEOR to develop evidence supporting Medicare coverage • Represent the company with CMS, Medicare contractors, and industry organizations • Serve as the company's primary expert on CMS coverage policy, Medicare Administrative Contractors, coding processes, reimbursement methodologies, and federal regulatory developments affecting genomic sequencing and genetic testing • Work with Government Affairs, Medical Affairs, HEOR, Clinical Affairs, Regulatory Affairs, and Commercial teams to shape national reimbursement policy

🎯 Requirements

• Bachelor's degree required; advanced degree preferred (MPH, MHA, PharmD, PhD, JD, MBA, or equivalent) • 10+ years of experience in Medicare reimbursement, federal health policy, or market access • Experience leading Medicare coverage and reimbursement strategies for genomic sequencing, genetic testing, molecular diagnostics, precision medicine, or other advanced diagnostic technologies • Over 5 years of direct experience working with CMS, Medicare Administrative Contractors (MACs), MolDx, or other Medicare reimbursement and policy organizations • Demonstrated success influencing Medicare coverage, coding, pricing, or reimbursement policy • Deep knowledge of NCDs, LCDs, CLFS, CPT and PLA coding, gapfill and crosswalk pricing, and Medicare payment policy • Excellent policy analysis, stakeholder engagement, and executive communication skills • Approximately 25–35% travel • This role is not eligible for visa sponsorship

🏖️ Benefits

• Variable cash program (bonus or commission) • Equity for eligible roles • Access to genomics sequencing • Family planning benefits • Health, dental, and vision benefits • Retirement benefits • Paid time off • Employee Resource Groups offering career development experiences, cultural awareness, and social responsibility opportunities