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Job Reference:

Director of Managed Care

Continent: North America
Location: California – remote
Market: scientific
Industry: Molecular Diagnostics
Salary: $180,000 – $200,000 + competitive bonus and benefits scheme

The Client: JBAndrews is partnering with a leading molecular diagnostics company providing a full spectrum of genetic testing services, including WES and WGS solutions for a range of disease states.

The company are seeking a Director of Managed Care to develop, negotiate, management, and renegotiate the company’s local, regional and national contractual relationships with managed care organizations and other third-party payers. This position will be responsible for a small team of individuals and building out the Outbound Market Access team and workflow for the US market to track, measure, and improve support for Sales & Marketing.

Role:

  • Negotiate local, regional, and national managed care contracts with leading managed care organizations and other third-party payers
  • Structure, hire, lead, and develop a team focused on the managed markets business with the intent of delivering broad payer coverage while exceeding revenue goals
  • Ensure compliance with Medicare and Medicaid guidelines and other managed care policies
  • Expand medical policy to match pace with product innovation
  • Work cross functionally to develop and implement value-based/outcome based contracting strategy with payers
  • Work collaboratively with counterparts, including sales leaders, customer success, medical affairs, market access, billing, legal, finance, product development, and marketing on strategic business development efforts to ensure coverage, access, and reimbursement of products

Requirements:

  • 8+ years professional experience in Managed Care or Contracting in a life sciences, payer setting
  • 3+ years management experience with a managed care team
  • Bachelor’s degree required; graduate degree in a related field such as public health or public policy preferred
  • Experienced working with payers as a laboratory that bills molecular tests.
  • Experience and knowledge of federal and state legislative environments and regulatory processes to dissect complex scenarios and are able to bring issues to swift resolution.
  • Expert in medical billing, third party payers and patient interface, patient privacy and confidentiality paramount.
  • Follow payer policy activities on coverage and payment technology processes and practices

Due to the large number of applications if you have not heard anything within 14 days then unfortunately you have been unsuccessful.

About JBAndrews – Global Solutions

JBAndrews is a leading executive search and selection business, based in Leeds. We provide retained and contingency recruitment solutions globally, specializing in the global Logistics & Supply Chain, Industrial & Finance Sectors.

 

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Job Reference:

Director of Managed Care

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