Director, Market Access – CMS Coverage & Reimbursement Policy

Illumina; United States; A distancia; USD 187.000 - 281.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health benefits

Retirement benefits

Paid time off

Descripción de la vacante

Illumina is seeking a Director, Market Access – CMS Coverage & Reimbursement Policy to lead Medicare coverage, coding, and reimbursement strategies for genomic sequencing and genetic testing. You will act as the primary CMS policy expert, guiding MAC engagement, CLFS pricing, and regulatory developments affecting access to genomic testing.

You will collaborate with Government Affairs, HEOR, Clinical Affairs, and Regulatory teams to develop evidence-based strategies that improve beneficiary

Formación

• Bachelor’s degree required; advanced degree preferred.
• 10+ years of experience in Medicare reimbursement, federal health policy, or market access.
• Demonstrated experience leading Medicare coverage and reimbursement strategies for genomic sequencing or molecular diagnostics.
• 5+ years working with CMS, MACs, MolDx, or related Medicare policy organizations.

Responsabilidades

• Lead Medicare market access strategies for genomic sequencing and genetic testing.
• Develop strategies for NCDs, LCDs, MolDx, MAC engagement, CPT/PLA coding, and reimbursement.
• Monitor CMS rulemaking and federal reimbursement policy developments.
• Partner with Government Affairs on federal advocacy and policy.
• Collaborate with Medical Affairs and HEOR to develop evidence supporting Medicare coverage.
• Represent the company with CMS, Medicare contractors, and industry organizations.

Conocimientos

Medicare reimbursement

Federal health policy

Market access

CMS policy

Coding & pricing (CPT/PLA)

Stakeholder engagement

Executive communication

Educación

Bachelor’s degree

Advanced degree (MPH/MHA/PharmD/PhD/JD/MBA)

Descripción del empleo

What if the work you did everyday could impact the lives of people you know? Or all of humanity?

At Illumina, we are expanding access to genomic technology to realize health equity for billions of people around the world. Our efforts enable life-changing discoveries that are transforming human health through the early detection and diagnosis of diseases and new treatment options for patients.

Working at Illumina means being part of something bigger than yourself. Every person, in every role, has the opportunity to make a difference. Surrounded by extraordinary people, inspiring leaders, and world changing projects, you will do more and become more than you ever thought possible.

The Director, Market Access – CMS Coverage & Reimbursement Policy will lead the company’s strategy for Medicare coverage, coding, reimbursement, and federal payment policy affecting genomic sequencing and genetic testing. This individual will serve as the company’s primary expert on CMS coverage policy, Medicare Administrative Contractors (MACs), coding processes, reimbursement methodologies, and federal regulatory developments impacting access to genomic sequencing and genetic testing.

Working closely with Government Affairs, Medical Affairs, HEOR, Clinical Affairs, Regulatory Affairs, and Commercial teams, this leader will develop evidence-based strategies that improve Medicare beneficiary access while shaping national reimbursement policy.

Responsibilities

• Lead Medicare market access strategies for genomic sequencing and genetic testing.
• Develop strategies for NCDs, LCDs, MolDx, MAC engagement, CLFS pricing, CPT/PLA coding, and reimbursement.
• Monitor CMS rulemaking and federal reimbursement policy developments.
• Partner with Government Affairs on federal advocacy and policy initiatives.
• Collaborate with Medical Affairs and HEOR to develop evidence supporting Medicare coverage.
• Represent the company with CMS, Medicare contractors, and industry organizations.

Requirements

• Bachelor’s degree required; advanced degree preferred (MPH, MHA, PharmD, PhD, JD, MBA, or equivalent).
• 10+ years of experience in Medicare reimbursement, federal health policy, or market access.
• Demonstrated experience leading Medicare coverage and reimbursement strategies for genomic sequencing, genetic testing, molecular diagnostics, precision medicine, or other advanced diagnostic technologies.
• Over 5 years of direct experience working with CMS, Medicare Administrative Contractors (MACs), MolDx, or other Medicare reimbursement and policy organizations. Ideal candidates would have worked at CMS.
• Demonstrated success influencing Medicare coverage, coding, pricing, or reimbursement policy.
• Deep knowledge of NCDs, LCDs, CLFS, CPT and PLA coding, gapfill and crosswalk pricing, and Medicare payment policy.
• Excellent policy analysis, stakeholder engagement, and executive communication skills.

Travel

Approximately 25–35% travel.

The estimated base salary range for the Director, Market Access – CMS Coverage & Reimbursement Policy role based in the United States of America is: $187,400 - $281,000. Should the level or location of the role change during the hiring process, the applicable base pay range may be updated accordingly. The range reflects long‑term growth in the role; therefore, most candidates are hired between the minimum and middle of the range. Placement depends on experience, skills, location, and internal equity. Additionally, all employees are eligible for one of our variable cash programs (bonus or commission) and eligible roles may receive equity as part of the compensation package. We offer a wide range of benefits as innovative as our work, including access to genomics sequencing, family planning, health/dental/vision, retirement benefits, and paid time off.

We are a company deeply rooted in belonging, promoting an inclusive environment where employees feel valued and empowered to contribute to our mission. Built on a strong foundation, Illumina has always prioritized openness, collaboration, and seeking alternative perspectives to propel innovation in genomics.

We are proud to confirm a zero-net gap in pay, regardless of gender, ethnicity, or race.

We also have several Employee Resource Groups (ERG) that deliver career development experiences, increase cultural awareness, and offer opportunities to engage in social responsibility.

We are proud to be an equal opportunity employer committed to providing employment opportunity regardless of sex, race, creed, color, gender, religion, marital status, domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, sexual orientation, pregnancy, military or veteran status, citizenship status, and genetic information.

Illumina conducts background checks on applicants for whom a conditional offer of employment has been made. Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable local, state, and federal laws. Background check results may potentially result in the withdrawal of a conditional offer of employment. The background check process and any decisions made as a result shall be made in accordance with all applicable local, state, and federal laws.

Illumina prohibits the use of generative artificial intelligence (AI) in the application and interview process.

If you require accommodation to complete the application or interview process, please contact [e-mail].

To learn more, visit: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf.

The position will be posted until a final candidate is selected or the requisition has a sufficient number of qualified applicants.

This role is not eligible for visa sponsorship.