Director Market Access Value-based Accounts

Director Market Access Value-based Accounts

Requirements

• Established deep and wide relationships with payors, IDNs, IPAs, MCOs, and public health systems
• Deep understanding of the U.S. healthcare reimbursement landscape, including knowledge of payer systems and medical policy, specifically in the diagnostics space
• Strong team player with experience working with cross-functional teams (billing, analytics, sales, marketing, medical, etc.)
• Excellent strategic thinking skills, with demonstrated ability to successfully lead the ideation, development of a plan, and move to action
• Excellent written and verbal communication skills with the ability to maintain open communication with people of all backgrounds and expertise inside and outside Veracyte
• Ability to translate complex medical messages into communications that are understood by each target audience
• Warm, engaging personality with highly developed influencing skills and ability to represent Veracyte and its products/services with credibility
• Understand health economic models, coordination with medical personnel, KOLs and consultants to produce compelling demonstrations of value
• Impeccable ethics, conducting business in the most professional manner possible
• Desire to help patients by improving access to quality diagnostic testing

Responsibilities

• Manage and track state Medicaid credentialing, coverage policies and reimbursement rates relevant to Veracyte’s portfolio of products
• Identify gaps in state Medicaid reimbursement and prioritize activities such as credentialing, enrollment, coverage, establishing fee schedule rates, and contracting with MCOs
• Support state-level government affairs initiatives such as ensuring proper implementation and application of state biomarker laws relevant to our portfolio of products
• Implement state-level appeals strategy in collaboration with Billing
• File complaints where appropriate with state departments of insurance
• Implement engagement strategy with health plans and LBMs that are not aligned with state biomarker laws
• Collaborate closely with field sales to grow accounts where reimbursement issues have limited access; this will require in-person co-selling
• Gain physician and administrative support
• Contract where needed
• Respond to RFPs from public health systems such as county hospitals
• Partner with the broader Market Access team, Billing, Marketing, Medical team, and consultants to improve reimbursement and revenue
• Develop and maintain an operating plan that tracks KPI and provides forecast for future contracts, coverage, and new account opportunities
• Gain and develop a deep understanding of Veracyte’s entire portfolio of products, trends in healthcare reimbursement, and each account’s challenges and initiatives to inform reimbursement strategy
• Coordinate with various global corporate functions to build evidence of value demonstration across multiple products

Preferred Qualifications

• Bachelor’s degree required, PhD or other advanced degree preferred
• 5+ years of work experience in market access/payer relations/managed care/health economics in the diagnostics space
• Prefer experience at a diagnostics lab with a menu of proprietary advanced genomic “laboratory developed tests”
• Extensive experience working with state Medicaid programs and payers with alternative payment models is required
• Experience with state-level government affairs is preferred but not required
• The business opportunity requires this field-based position to be located on the West Coast, preferably in California
• Proficient in Teams, Powerpoint, Excel and Tableau
• Flexibility to travel 20-40% of the time to meet with accounts, payors and attend industry events domestically