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Market Access, Reimbursement, Payer Policy Associate Director

LabCorp

This is a Full-time position in Tustin, CA posted November 22, 2021.

Labcorp has an opportunity for a Market Access, Reimbursement, Payer Policy Associate Director covering our Western divisions of the United States.

The Market Access, Reimbursement, Payer Policy Associate Director will report to the Vice President, Payer Solutions West.

The selected candidate will work independently under general guidance usually with some latitude for independent judgment and initiative.

Principal Functional Responsibilities:

  • Execute on the enterprise Payer and Specialty Testing team strategies in response to specialty test offerings, new clinical research studies, general payer coverage policies and new/updated clinical guidelines.
  • Train the Payer Solutions team on how to position Labcorps specialty testing offering value proposition to include but not limited to genetics, anatomic pathology, and esoteric testing.

    Team should be adept at both communicating clinical utility and cost effectiveness, along with handling objections, taking into consideration the Payers existing coverage and Utilization Management policies, the current gold standards of treatment and continuum of care, and competitive offerings.

  • Support the Payer Solution Executives efforts to secure positive coverage and target reimbursement for new and specialty tests, including but not limited to the support of fee for service reimbursement outside of capitation arrangements for such tests.
  • Support Payer Solutions Executives efforts to reduce administrative requirements for specialty testing, including limiting tests included in prior authorization programs and relaxation of these programs requirements.
  • Support the Payer Solution Executives efforts to secure coverage and target reimbursement for new technology and focus tests, including but not limited to the support of fee for service reimbursement outside of capitation arrangements for such tests.
  • Educate Payer Solutions team on new technology, pricing guidelines, clinical positioning and reimbursement strategy for specialty testing.
  • Review and support the responses to proposals, presentations, and contracts.

    With the Payer Solutions Executive, support efforts to negotiate and secure target pricing for specialty tests.

  • Develop annual business plans, to be included in broader Divisional Payer market annual plans, that will improve Labcorps specialty testing reimbursement.
  • Stay informed on the latest clinical utility study data and findings, specialty society guideline changes and payer policy changes relating to our specialty testing.
  • Stay informed of developments and trends relating to all areas of the company and managed care plans.

** This job description reflects only the essential functions of the position and excludes those which may be incidental to the performance of the job.

In no way it is stated or implied that the principal functions are the only duties to be performed.

Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by supervisor.

Requirements

License/Certification/ Education: Normally B.S.

Degree required w/5+ years of experience.

Preferred degree(s): Business; Business Administration, Science or related degree Strongly preferred:B.A.

in Business; Master of Science (MS) Healthcare Management

Normally requires a Valid Drivers License along with a clean driving record.

Knowledge | Skills | Abilities | Experience

  • Proven track record of implementing successful market access plans for new technologies, including obtaining positive coverage policy changes and securing appropriate reimbursement
  • Knowledge of principles of Managed Care, including plan types (HMOs, PPOs, etc.), and understanding of progressive health care dynamics including value based care and risk-sharing arrangements
  • Experience developing relationships with payer network, clinical and medical leadership.

    Diagnostics background, to include sales, a plus

  • Experience with oncology and reproductive genetics market is strongly desired
  • Strong presentation skills and superior negotiation, analytical, communication and PC skills
  • Ability to serve as internal SME for managed care and diagnostic specialty sales teams for genetic, pathology, and esoteric testing
  • Understanding of capitated and fee-for service reimbursement arrangements, along with knowledge of CPT and ICD-10 coding

Shift

1

Schedule

Monday
– Friday, 8am to 5pm

Applicants from CA, WA, NV, NM, AZ, UT, CO are strongly encouraged to apply.