Vice President, Reimbursement and Health Policy

16 Jul, 2020

Jobs

Vice President, Reimbursement and Health Policy

Freenome
South San Francisco, CA

About the Role

The Vice President, Reimbursement and Health Policy reports to Freenome’s Chief Medical Officer and is responsible for leading and directing the overall reimbursement roadmap and health policy initiatives for the organization. This person will be responsible for proactively translating organizational objectives into an advocacy and engagement strategy that considers all appropriate stakeholders, and for anticipating and responding to changes in the reimbursement and regulatory environments. The Vice President, Reimbursement and Health Policy must align internal business partners and leverage internal expertise to help shape public debate when appropriate.

How you’ll contribute: 

Reimbursement 

  • Work closely with the Company’s leadership team to create and implement a comprehensive reimbursement strategy, and establish clear metrics to measure success
    • Lead and execute coding strategy, AMA CPT application process, Pathology Coding Caucus strategy and tactical execution to obtain CPT code
    • Establish appropriate value-based reimbursement with CMS and payer community including, Medicaid and Commercial Payers
    • Develop and implement a strategy for review and successful inclusion in guidelines (e.g., USPSTF, MSTF, and NCCN)
    • Develop launch strategy for top-down and bottom-up coverage by National, Tier 1 and Tier 2 regional payer plans
  • Develop best-in-class internal and third-party resources such as geo-targeting campaigns, patient advocacy support, and reimbursement materials at launch
  • Develop and implement a strategic plan for key national payer accounts (public and private) with specific measurable objectives that support the business plan for each payer type.
  • Set strategy and direction for educating and influencing key payer decision-makers while promoting appropriate utilization of the Company’s products. Direct development of dossiers for reimbursement and coverage purposes of each product
  • Cultivate a professional line of communication and maintain relationships with key thought leaders in the national payer market and promote appropriate utilization of the Company’s products to key decision-makers, thought leaders and advocacy groups (e.g., USPSTF, ACS, AdvaMed Dx, ACLA, CCLA, CAP, AMP, Prevent Cancer and clinical guideline bodies)
  • Collaborate with the relevant commercial and clinical groups within the Company to maximize coverage and reimbursement for all the Company’s current and future products
  • Serve as the link to field sales organizations, marketing, and sales management to communicate payer trends, challenges, and outcomes
  • Coordinate triage of reimbursement challenges to leadership for guidance and support

Health Policy

  • Develop, implement, and lead a strategic approach to engage business leadership with the goal of identifying and prioritizing proactive legislative and regulatory (rule making) initiatives that support key business objectives and drive business development opportunities. Develop appropriate policy positions with business leadership to ensure consistency of messaging and coordination with the business.
  • Translate the Company’s business agenda into a national and applicable state-level policy strategy. Articulate, advance, and implement a strategic and tactical approach and advocacy agenda in support of the organization’s priorities and efforts.
  • Identify and advance business opportunities (also minimizing potential business threats), keep business segment leadership informed of key public policy activities and developments within Congress, the Administration and key agencies
  • Aggressively pursue opportunities to engage third-party stakeholders and policy decision-makers to extend thought leadership and policy objectives
  • Identify opportunities to  lead public dialogues to advance the Company’s interests
  • Monitor the political and regulatory landscape for threats and opportunities to the organization and effectively communicate this intelligence to business leadership. This will include ongoing analysis of such developments that includes describing the potential impact of the action(s) on the business, working out various scenarios, and recommending appropriate positions and responses.
  • Manage Freenome’s relationships with key US agencies and officials in Washington, DC, and key states, including frequent, proactive interaction to ensure that the Company’s short- and long-term interests are understood and supported. This will also entail educating officials about the value of the company to maintain a favorable and positive reputation.
  • Engage in advocacy initiatives with industry members, trade associations, lobbyists, and other companies to proactively ensure that the organization’s positions are understood and reflected in the development of industry positions. This also may require taking leadership positions within associations through various task forces, sub-committees,  and working groups, primarily focused on issues the Company determines important from time to time.
  • Support and facilitate opportunities for Freenome executives to interact with key policy-makers, officials, association partners, thought leaders, and other stakeholders.
  • Draft, disseminate, summarize, and analyze public policy positions on key business priorities to ensure consistency of messaging and coordination throughout the organization, and support external positioning and advocacy efforts related to:
    • the handling of various proposals at the federal and state levels
    • opportunities for proactive positioning/agenda-setting
  • Contribute to opportunities identified by colleagues on the business development, intellectual property, and commercial teams
  • Work with internal subject matter leads and business leadership to ensure consistency and coordinated engagement and manage any inter-business policy conflicts
  • Identify ways to enable the Company to leverage government incentives and stimulus programs
  • Identify opportunities and develop mechanisms for mobilizing grassroots lobbying campaigns
  • Develop and implement a political compliance program to educate impacted employees and directors to help ensure compliance with applicable federal, state and local lobbying and ethics laws/regulations, including pay-to-play requirements

What you’ll bring:

  • Advanced degree, JD, MBA or MPA, preferred
  • At least 10 years of biotech and/or pharma experience pursuing and obtaining reimbursement coverage for novel diagnostic medical devices and/or new diagnostic tests
  • At least 10 years of industry experience in government/regulatory affairs
  • Successful experience with USPSTF, health economic and outcomes research (HEOR) studies strongly preferred
  • Billing/claims adjudication strongly preferred
  • Strong decision-making skills with a keen understanding of customer-focused negotiation, private and public payer markets, strategic planning and field sales leadership
  • Ability to develop and maintain strong internal and external relationships while enhancing the company’s policy and legislative positions
  • Strong communication and diplomatic skills with the ability to give presentations to a wide spectrum of audiences, both internally and externally
  •  Outstanding interpersonal skills, with the ability to establish rapport and credibility with key individuals and to build and maintain a broad network of relationships in the preventive health services field
  • Strong commitment to integrity and teamwork with proven ability to work collaboratively across teams, departmental and industry boundaries
  • Successful track record of being a leader in policy setting environments such as in-house at a corporation, a trade association, or in a relevant Department or Agency
  • Superior oral and written communication skills, with the ability to persuasively and succinctly communicate complex concepts and programs at the highest levels of business and government

 

About Freenome

Freenome is a biotechnology company that has pioneered the most comprehensive multiomics platform for early cancer detection through a routine blood draw. By combining a deep expertise in molecular biology with advanced computational biology and machine learning techniques to recognize disease-associated patterns among billions of circulating, cell-free biomarkers, Freenome is developing simple and accurate blood tests for early cancer detection and integrating the actionable insights into health systems to operationalize a machine learning feedback loop between care and science. Freenome is headquartered in South San Francisco, California. For more information about Freenome, visit www.freenome.com and view open positions at freenome.com/careers.

The company has raised $238 million from investors such as RA Capital, Polaris Partners, Perceptive Advisors, Andreessen Horowitz, funds and accounts advised by T. Rowe Price Associates, Inc., GV (formerly Google Ventures), Roche Venture Fund, Novartis, Kaiser Permanente Ventures, American Cancer Society’s BrightEdge Ventures, Data Collective Venture Capital, Novartis, and Verily Life Sciences (formerly Google Life Sciences).

Our Science

Freenome is building technology to gain an understanding of the body through several analytes derived from blood. These signals include cell-free DNA, methylation of cell-free DNA, cell-free RNA, circulating proteins, and immune profiling derived from thousands of prospective samples. By developing novel statistical learning methods and applying them to integrate various -omics datasets, Freenome is a leader in modeling specific biological mechanisms to capture disease dependent signatures such as gene expression, immune response, tumor burden, the tissue of origin, and 3D chromatin structure.

By building comprehensive discovery datasets and modeling critical biological systems, Freenome is learning what biological changes are present within the blood between a variety of different disease states including cancer, autoimmune disorders, infections, drug response, and aging. With the combination of Freenome’s datasets, cross-functional technical expertise, and mission to uncover the biological truth, we seek to positively change the lives of millions through the early detection and early treatment of disease.

Our Culture

Freenomers are technical and creative, visionary and grounded, empathetic and passionate. We build teams around divergent expertise, which allows us to solve problems and uncover opportunities in unique ways. Freenomers are some of the most talented experts in their fields, coming together to advance healthcare one breakthrough at a time.

We value empathy, integrity, and trust in one another. That means embracing other’s perspectives, those of our coworkers and those of the patients and communities we serve. It means knowing when to push, and when to listen. At Freenome, we give each other the benefit of the doubt in the belief that we’re all working as a team toward the same goals, and empower others to grow in a collaborative environment.

What does a successful person look like at Freenome?

Those who thrive at Freenome prioritize, manage, and execute their own goals in alignment with those of the company. They embrace our values of empathy, integrity, and trust, and hold themselves and their team accountable. They crave collaboration with brilliant minds from unfamiliar fields of study and believe that hiring and mentorship are fundamental to our success. Above all, they welcome and provide constructive feedback and criticism, trusting in the good intentions of others, and secure in the knowledge that embracing mistakes is the best way to learn and move on. For those who crave challenges, understudied problems, and the chance to see their work impact the lives of millions of people affected by cancer every year, there’s no better place to be.

Freenome is proud to be an equal opportunity employer and we value diversity in every way.  Freenome does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law.

Learn more here

Job posted: 2020-07-16