Manager, Payer Relations

4 weeks ago


Pittsburgh, United States Interpace Diagnostics Group Full time
Job DescriptionJob Description

Development and Implementation of Strategic Market Access Functions:

  • Lead initiatives to understand, analyze and demonstrate the clinical, economic and societal value to payers, decision-makers and influencers.
  • Establish favorable coverage policies with commercial payers for IDX tests.
  • Establish commercial payer contracts for IDX tests.
  • Identify main external stakeholders and establish relationships with influencers and decision makers to facilitate optimal access for existing and new products.
  • Develop the US market access value proposition and value dossier for IDX portfolio and advocate on data and publication opportunities that ensure access.
  • Interact closely with marketing and commercial team to develop payer marketing strategies, tactics, and initiatives to communicate value to customers and improve market access.
  • Lead the development of payer and channel customer business plans and negotiation strategy to drive access for appropriate patients.
  • Develops solutions for the customer facing team with any customer-specific product access or reimbursement issues.
  • Support negotiations with key assigned commercial/government payer and channel accounts.
  • Ensures continued positive payer coverage for IDX products through refinement of existing strategies and collaboration with partner commercial operations functional leads to ensure effective implementation of those strategies.
  • Prepare required reimbursement education material for internal and external stakeholders.
  • Regularly communicate customer and market dynamics that impact the business to IDX leadership team for business planning purposes.
  • Provide market access support for pipeline assets development.
  • Contribute to government pricing considerations and reporting.
  • Ensure compliance with law requirements.

Requirements

  • 5 years minimum experience of calling on national, and regional commercial payers, MACs, and CMS.
  • 5 years minimum experience calling on medical directors, and commercial payer contract managers.
  • 5 years minimum experience driving market access initiatives within the diagnostic laboratory, medical device or capital equipment markets.
  • Strong understanding of the US payer environment, and dynamics; with expert knowledge of U.S. managed markets including commercial and government payers as well as key channel segments.
  • Established relationships with national payer and channel customers.
  • Track record of building and maintaining relationships with key stakeholders and Commercial, Medicare and Medicaid payers. Successful track record managing activities through others.
  • HEOR experience a plus.

Strategic Development and Monitoring of Industry Trends

  • Analyze and monitor emerging trends in US health care delivery to help guide and inform IDX strategic objectives and implementation of commercial functions.
  • Collaborates with internal functions to prepare to meet emerging industry trends.
  • Updates personal job knowledge of people leadership and management by participating in educational opportunities, reading professional publications, maintaining personal networks.


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