Associate Director, Market Access & Reimbursement

EPM Scientific; Cleveland (OH); Presencial; USD 128.000 - 173.000; Jornada completa

Descripción de la vacante

EPM Scientific in Cleveland, PA, seeks a Senior Manager / Associate Director of Market Access & Reimbursement to lead payer coverage, coding, and reimbursement strategies across a growing diagnostics portfolio.

This highly visible role partners with commercial, clinical, billing, marketing, and R&D teams to drive favorable coverage decisions, payer adoption, and long-term market access success, ensuring the clinical and economic value of diagnostic technologies is clearly demonstrated.

Formación

• Bachelor's degree in a relevant field; advanced degree beneficial.
• 10+ years of healthcare industry experience.
• 7+ years in market access, reimbursement, or payer strategy.
• Strong understanding of coverage, coding, payment, and reimbursement within the diagnostics industry.
• Experience supporting LDTs and/or IVDs.
• Deep knowledge of HEOR, reimbursement policy, and health systems.
• Experience engaging commercial payers and government reimbursement stakeholders.
• Ability to thrive in fast-paced, evolving environments.
• Excellent communication, presentation, and cross-functional collaboration skills.

Responsabilidades

• Develop and execute coverage, coding, and payment strategies for diagnostic products.
• Secure CPT, PLA, ICD-10 and other coding pathways as needed.
• Create payer value dossiers and evidence packages to support coverage decisions.
• Collaborate with clinical development to align endpoints with payer evidence needs.
• Monitor reimbursement trends and market dynamics to inform strategy.
• Partner with billing and reimbursement stakeholders to evaluate payer performance.
• Build relationships with payers and Medicare contractors.
• Present clinical and economic evidence to support coverage decisions.
• Work with HEOR partners on cost-effectiveness and budget impact models.
• Engage clinicians and advocacy groups to support payer adoption.

Conocimientos

Payer strategy

Market access

HEOR

Healthcare industry experience

Communication skills

Presentation skills

Cross-functional collaboration

Strategic thinking

Educación

Bachelor's degree

MBA or advanced degree

Descripción del empleo

Associate Director, Market Access & Reimbursement (PR/613033) Cleveland, Pennsylvania

Salary: USD150000 - USD150000 per year

An innovative organization in the precision diagnostics space is seeking a Senior Manager / Associate Director of Market Access & Reimbursement to lead reimbursement and access strategy across a growing diagnostics portfolio. This highly visible role will be responsible for developing and executing payer coverage, coding, and reimbursement strategies that ensure broad patient access while demonstrating the clinical and economic value of diagnostic technologies.

The successful candidate will partner cross-functionally with commercial, clinical, billing, marketing, and R&D teams to drive favorable coverage decisions, payer adoption, and long-term market access success.

Key Responsibilities

Strategic Reimbursement Planning

• Develop and execute coverage, coding, and payment strategies for both existing and pipeline diagnostic products.
• Secure and maintain appropriate CPT, PLA, ICD-10, and other coding pathways as needed.
• Create payer value dossiers, reimbursement materials, and evidence packages to support coverage decisions.
• Collaborate with clinical and development teams to ensure study endpoints address payer evidence requirements, including clinical utility and health economic outcomes.
• Monitor reimbursement trends, policy changes, competitive landscapes, and market dynamics to inform strategy.
• Partner with internal billing and reimbursement stakeholders to evaluate payer performance and identify opportunities for improvement.
• Establish and maintain relationships with regional and national commercial payers, Medicare contractors, and key reimbursement stakeholders.
• Present clinical, economic, and outcomes-based evidence to support positive coverage policy decisions.
• Collaborate with health economics and outcomes research partners to develop cost-effectiveness and budget impact models.
• Work alongside commercial and marketing teams to engage clinicians, advocacy organizations, and other stakeholders that support payer adoption.

Cross-Functional Leadership

• Provide market access expertise to R&D, clinical development, and commercialization teams.
• Advise on clinical utility study design and evidence-generation activities.
• Support training initiatives related to reimbursement processes, billing workflows, and prior authorization requirements.
• Partner with sales leadership to communicate reimbursement updates, payer policy changes, and contracting developments that impact field teams and key accounts.
• Ensure all activities comply with applicable healthcare regulations, policies, and compliance standards.

Qualifications

Required

• Bachelor's degree in a relevant field; advanced degree considered beneficial.
• 10+ years of healthcare industry experience.
• 7+ years of market access, reimbursement, or payer strategy experience.
• Strong understanding of coverage, coding, payment, and reimbursement within the diagnostics industry.
• Demonstrated success supporting both laboratory-developed tests (LDTs) and/or in vitro diagnostics (IVDs).
• Deep knowledge of managed care, health economics and outcomes research (HEOR), reimbursement policy, and health systems.
• Experience engaging commercial payers and government reimbursement stakeholders.
• Ability to thrive in fast-paced, evolving, and entrepreneurial environments.
• Excellent communication, presentation, and cross-functional collaboration skills.

Preferred

• MBA or other advanced degree.
• Experience supporting oncology diagnostics, precision medicine, advanced diagnostics, or point-of-care testing technologies.
• Prior experience building market access strategies for innovative diagnostic products.