Director, Market Access and Medical Policy, Specialty Testing

Recognized as one of Forbes 2024 “America's Best Large Employers” and named to the Forbes 2024 "Best Employers for Diversity", Labcorp is seeking to hire a national Director of Market Access and Medical Policy, Specialty Testing.

This position has the responsibility of working collaboratively across Labcorp’s clinical, marketing and business development areas to develop market access strategies for novel technologies. In addition, this position will have primary responsibility for developing and implementing a comprehensive payer strategy that optimizes brand strategy and value proposition of LabCorp's specialty and genetic testing services.

The Director of Market Access and Medical Policy will report to the Vice President, Payor Solutions, Market Access. The selected candidate will work independently under general guidance usually with some latitude for independent judgment and initiative.

This position is remote in the US.

Principal Functional Responsibilities:

• Serve as national specialty testing payor solutions lead in new test development initiatives, informing of reimbursement and market access potential for specialty testing. 

• Be adept at both communicating and conversing in clinical utility and cost effectiveness for specialty tests in support of improving market access and reimbursement. Provide expert insight into reimbursement and coverage scenarios for novel technologies prior to acquiring or developing technologies.

• Serve as managed care subject matter expertise as member of cross functional team that will be responsible for developing market access plans for novel technologies. 

• Work with clinical resources to evaluate current literature as it relates to analytical and clinical validity and clinical utility. Identify gaps and support development of a publication strategy.

• Support development of proposals for clinical studies to ensure the study outcomes will support positive medical policies. Identify partners and opportunities to engage payers in clinical utility studies.

• Develop opportunities to engage managed care KOLs to serve as consultants and potentially members of a managed care medical advisory board.

• As part of market access planning, this position will lead commercial reimbursement strategy for his/her portfolio of assays, collaborating with National VP Clinical Effectiveness, coding team, and RCM.

• Collaborate with marketing to develop payer messaging, as well as ensuring physician messaging is consistent with test positioning for new product launches.

• Lead conversations with national payer medical directors and medical policy teams to secure coverage, targeted reimbursement, and to remove administrative barriers to reimbursement.

• Coordinate with RCM to ensure Labcorp is recognizing revenue consistent with reimbursement and coverage policies. Identify opportunities and develop strategies to improve reimbursement experience. 

• Educate Payor Solutions Executive team on new test offerings, payer policies, reimbursement, pricing guidelines and positioning for specialty testing.

• 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.

• Travel can be up to 25%.

Requirements

• License/Certification/ Education:

  • Normally B.S. Degree required w/10+ years of experience. Preferred degree(s): Business; Business Administration, Science, or related degree

  • Strongly preferred: Master’s Degree in Life Sciences, Pharm D., 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 specialty diagnostic tests.

• Demonstrated ability to Identify and cultivate relationships with key contacts within payers, including health plans, laboratory benefit managers and pharmacy benefit managers. Key contacts include Medical Directors, medical policy, medical management, and pricing/reimbursement personnel.

• 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 assigned areas of spe