The Manager of Clinical Payor & Policy Relations

25 Oct, 2021

Jobs

The Manager of Clinical Payor & Policy Relations

TECH-RBM
Dallas, TX

Job Description

Position Summary:

The Manager of Clinical Payor & Policy Relations will be responsible for research and promotion of positive medical policy coverage for Caris Molecular Intelligence (CMI) testing services. They will assist the Market Access team with the overall development and implementation of value propositions, access strategy and payer tactics. This position will develop working relationships with higher level external partners and collaborate with internal colleagues from other functional areas.

Job Responsibilities:

  • Develop a clear value proposition to payors and other key opinion leaders that will influence medical policy and expand positive payor coverage.
  • Collaborate with the Market Access team to develop and execute payor outreach strategies to support optimal access and coverage of current and emerging CMI products in the pipeline.
  • Support a teamwork approach engaging with various internal and external collaborators on strategic reimbursement plans.
  • Develop and provide support for the creation of payor directed-materials, value dossiers, payor conference messaging, presentations, and other payor-focused communication and educational tools.
  • Assess clinical evidence and gaps that may influence payor coverage determinations.
  • Assist in collaborative efforts on health economic and clinical utility studies that support payor coverage and reimbursement.
  • Maintain current knowledge on evolving payor landscape and track changes in commercial and government payors’ coverage policies and update leadership of opportunities for broader patient access and reimbursement.
  • Partner with field-based teams in the execution of both national and regional reimbursement strategies to achieve short and long term business objectives.

Required Qualifications:

  • Knowledge of managed care landscape and/ or insurance industry.
  • Ability to communicate technical and non-technical information to scientific and non-scientific colleagues/ clients.
  • Strong interpersonal and peer leadership skills to influence without authority.
  • Ability to thrive in a highly collaborative, fast-paced environment.
  • A strategic thinker with excellent verbal, written and presentation skills to get buy-in and drive consensus within the team and the rest of the organization.
  • Proficient understanding of healthcare delivery systems, specifically commercial and government-sponsored programs such as Medicaid and Medicare, and roles of key stakeholders.
  • Strong working knowledge of revenue codes, HCPCS, CPT codes, ICD-10 and provider classifications.
  • Proficient in Microsoft Office Suite, specifically Word, Excel, Outlook, and general working knowledge of Internet for business use.
  • Bachelor’s degree in a scientific or clinical and/or business area is required.
  • A minimum of 3 years of relevant market access and reimbursement experience within either biotech, medical device, or a molecular diagnostic laboratory.
  • Conditions of Employment: Individual must successfully complete pre-employment process, which includes criminal background check, drug screening and reference verification. Also, individual must be fully vaccinated for COVID-19 by the date of hire to be considered for U.S.-based jobs, if not currently employed by Caris Life Sciences

Preferred Qualifications:

  • Master’s degree in Life Sciences, Nursing, Public Health, or Genetic Counseling; Business and Healthcare Administration or related discipline strongly desired.
  • Ideally 5 or more years of relevant market access and reimbursement experience within either biotech, medical device, or a molecular diagnostic laboratory.
  • Strong competency of the US payer landscape and market drivers.

Core skills & Competencies:

  • Highly self-motivated, self-directed, and attentive to detail.
  • Ability to work in a complex and matrix team environment; experience working in a team-oriented, collaborative environment.
  • Proven abilities in leading complex problem management and process analysis.
  • Ability to handle multiple tasks, set priorities, schedule, and meet deadlines.
  • Proven abilities in problem management, process analysis and root cause analysis.
  • Strong interpersonal and relationship-building skills, with the ability to manage up, down and across levels of the organization.

Other:

  • Approximately 20% travel and the ability to work flexible hours when required.

Physical Demands:

  • Duties are performed in an office setting.
  • This position requires the ability to use a computer keyboard, read printed materials and communicate through email and over telephone.

Job posted: 2021-10-25