Laboratory Corporation of America Associate Director Market Access Reimbursement - West Region in Tustin, California
LabCorp has an opportunity for an Associate Director of Market Access and Medical policy covering the Northeast. The position has the responsibility of developing and implementing a comprehensive payer strategy that optimizes brand strategy and value proposition of LabCorp's Specialty Testing Group's focused products and services . The Associate Director of Market Access and Medical Policy will report to the Vice President, Managed Care, Specialty Testing. The selected candidate will work independently under general guidance usually with some latitude for independent judgment and initiative.
Principal Functional Responsibilities:
Identify and cultivate relationships with key contacts within health plans, including Medical Directors, medical policy, medical management and pricing/reimbursement personnel.
Articulate LabCorp's value proposition and communicate LabCorp's specialty test offering including, but not limited to, genetics, pathology, and esoteric testing to health plan and payer contracting and medical teams.
Be adept at both communicating and conversing in clinical utility and cost effectiveness for specialty tests in support of improving market access and reimbursement.
Collaborating with LabCorp IPA sales team to obtain contracts and reimbursement for LabCorp's specialty testing to achieve business goals.
Analyze reimbursement data in conjunction with medical policies to identify and prioritize opportunities to improve reimbursement experience of focus tests.
Improve reimbursement experience by improving coverage/medical policies and reducing administrative requirements for reimbursement.
Serve as national specialty managed care lead in new test development initiatives, informing of reimbursement and market access potential for reproductive genetic tests.
Educate Managed Care Executive team on new test offerings, on payer policies and reimbursement, and pricing guidelines and positioning for specialty testing.
Review and support the responses to proposals and contracts as it relates to focus tests and new technology. In collaboration w ith the Managed Care team , support efforts to negotiate and secure target pricing for targeted tests.
Keep informed of the latest clinical utility study data and findings, society guideline changes, payor policy changes, competitive offerings 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.
- 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: Master's Degree in Life Sciences, Business Administration or Public Health.
Knowledge | Skills | Abilities | Experience
Experience in developing and executing strategic plans to obtain optimal payer coverage/policies and reimbursement for key esoteric tests.
Capability to identify and cultivate relationships with key contacts within health plans, including Medical Directors, medical policy, medical management and pricing/reimbursement personnel.
Demonstrated success in negotiating agreements and reimbursement for specialty diagnostics with IPAs and medical management groups.
Knowledge of Managed Care and health care industry, including progressive health care dynamics; e.g. value based care and risk-sharing, and industry trends.
Strong presentation skills; superior negotiation; analytical and financial acumen; proficient in PowerPoint/Word/Excel; knowledge of CPT and ICD coding and processes.
Ability to serve as internal SME for managed care team for genetic, pathology, and esoteric testing.
Self-driven, passionate, innovative and able to manage multiple tasks in a fast paced environment.
Monday - Friday 8:00 am - 5:00 pm
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, national origin, sexual orientation, gender identity, disability or veteran status.