Market Access Channel Strategy Lead, Managed Care

 Posted 15 days ago
     
10+ years experience
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AI Summary

Responsible for achieving medical coverage policies and obtaining in-network contracts for genetic tests within the Northeast and Gulf regions. The role involves developing strategic account plans and building professional relationships with payer decision-makers.

Market Access Channel Strategy Lead, Managed Care will work with external customers in the Managed Care channel for the Northeast and Gulf Regions.  This is a director-level individual contributor role that is remote and field-based.  This position is responsible for achieving and maintaining medical coverage policies, garnering access, obtaining in-network contracts and monitoring market trends for clinical diagnostic laboratory genetic/genomic tests.  This position will be able to build strong business relationships in complex organizations.

QUALIFICATIONS:

Education:

  • Bachelor's degree required

Experience:

  • 8+ years of direct experience with U.S. payer accounts – proven past performance that has met or exceeded expectations
  • Must have previous experience with various health plans and preferably independent physician/practice associations (IPAs)
  • Demonstrated success in working with coverage policies and with closing contracts; reimbursement/managed care experience
  • Experience with NGS, molecular diagnostics, or genetics is a plus
  • Biopharma account management experience is welcome
  • Knowledge of the payer payment system in the U.S.
  • Ability to manage projects and work cross-functionally with other field teams (e.g., sales force) and home office team members (e.g., market access, medical affairs, etc.)
  • Ability to communicate effectively and persuasively on complex clinical and economic matters to payers and other customers
  • Clear commercial focus for influencing and negotiating with payer stakeholders across a wide variety of testing and disease areas
  • Intellectual curiosity and problem-solving skills

DUTIES AND RESPONSIBILITIES:

  • Achieve desired access and coverage decisions for BG tests by identifying, understanding, and addressing customer needs while generating potential solutions that enhance customer relationships
  • Meet or exceed account objectives for BG’s Northeast and Gulf regions
  • Grow existing customer managed care book of business; increase number of clients with in-network contracts
  • In collaboration with cross-functional BG teams, the account lead develops, evaluates and proposes strategic initiatives to strengthen mutual business opportunities, while developing account-specific strategies and tactical plans that align to the business and customer goals
  • Provides external insights to inform BG’s test access strategy
  • Develop short-term and long-term strategic account plans for assigned accounts
  • Presents BG-approved data and value messages compliantly with all governing policies
  • Builds and develops professional relationships with key customer decision-makers and related stakeholders within assigned accounts
  • Leads contract delivery, business reviews, and performance tracking for assigned accounts in collaboration with internal market access team
  • Conducts routine business reviews to inform internal stakeholders on relevant updates for assigned accounts
  • Uphold company mission and values; ensure compliance in all company policies and guidelines
  • Adheres to Code of Conduct as outlined in the Baylor Genetics Compliance Program
  • Performs other job-related duties as assigned.

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