Director, Market Access and Medical Policy, Women’s Health and Reproductive Genetics

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.

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 diagnostic testing services, with a focus on women’s health and reproductive genetics.

The Director of Market Access and Medical Policy will report to the Vice President, Payor Solutions.  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 payor solutions lead in new test development initiatives, informing of reimbursement and market access potential for genetic and specialty diagnostic testing. Provide expert insight into reimbursement and coverage scenarios for novel technologies prior to licensing, acquiring, and/or developing technologies.

• Be adept at interpreting medical policy and communicating and conversing in clinical utility and cost effectiveness for hereditary cancer genetic testing in support of improving market access and reimbursement. 

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

• Work with clinical resources to evaluate current literature as it relates to analytical and clinical validity and clinical utility. Identify gaps and collaborate with Medical Affairs to propose 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 payer reimbursement strategy for assigned 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 health plan 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. 

• Collaborate with government payor solutions and regulatory affairs teams to ensure market access needs are prioritized and support broader government payor and legislative efforts to improve access to genetic testing.

• Educate Payor Solutions 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:

  • B.S. Degree required; 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  

• 10+ years of experience in developing and executing strategic plans to obtain optimal payer coverage/policies and reimbursement.

• Experience in developing and executing strategic plans to obtain optimal payer coverage/policies and reimbursement for reproductive genetic testing and specialty diagnostics related to women’s health. 

• Experience in genetic and specialty diagnostics testing strongly preferred. Ability to serve as Labcorp SME for genetic testing for internal and external payor solutions needs. 

• Demonstrated ability to