Director, Market Access & Reimbursement Policy

Agendia; United States; On-site; USD 180,000 - 260,000; Full time

Job summary

Agendia is seeking a Director, Market Access, Reimbursement & Policy to lead payer coverage, reimbursement, and patient access across its precision oncology portfolio. You will develop and execute market access strategies, influence policy, and align evidence with payer requirements across commercial, medical, and government stakeholders.

Reporting to the Sr. VP, Reimbursement & Gov’t Affairs, you will partner with multiple functions to optimize access, coding, and pricing, while monitoring

Qualifications

• Bachelor's degree in Life Sciences, Healthcare Administration, Public Health, Health Policy, Business, or related discipline.
• 8+ years of progressive experience in market access, reimbursement, managed care, healthcare policy, health economics, or related healthcare functions.
• Experience within molecular diagnostics, genomics, oncology, biotechnology, laboratory medicine, or precision medicine.
• Strong understanding of U.S. commercial and government reimbursement systems, coverage policy development, and payer decision-making processes.
• Ability to influence senior stakeholders and lead complex cross-functional initiatives.
• Advanced degree (MBA, MPH, MHA, PharmD, PhD, or equivalent).
• Experience supporting precision oncology, genomic testing, or personalized medicine products.
• Familiarity with Medicare, CMS, MolDx, commercial payers, and laboratory benefit managers.
• Experience in health economics, outcomes research, evidence-generation strategy, or payer policy development.
• Expansion of favorable payer coverage and access across key commercial and government payer segments.
• Advancement of reimbursement strategies that improve payment performance and reduce systemic access barriers.
• Influence on payer policy, evidence generation, and stakeholder engagement initiatives that support long-term market adoption.
• Development of strategic partnerships with payers, laboratory benefit managers, policy leaders, and other key healthcare stakeholders.
• Delivery of actionable market access insights that inform business strategy, product planning, and evidence-development priorities.
• Leadership of cross-functional initiatives that enhance the value proposition and long-term commercial success of Agendia's genomic testing solutions.

Responsibilities

• Develop and execute market access strategies to grow adoption.
• Identify opportunities and risks related to reimbursement and policy.
• Provide strategic guidance on market access trends and dynamics.
• Support access planning for new products and evidence initiatives.
• Lead payer coverage, coding, and reimbursement initiatives.
• Assess payer policies and utilization management requirements.
• Collaborate with Revenue Cycle Management and Commercial teams.
• Monitor regulatory developments affecting precision oncology.
• Build relationships with health plans and policy organizations.
• Represent Agendia in payer discussions and advisory boards.

Skills

Strategic Leadership

Executive Presence

Market Access

Reimbursement Expertise

Business & Financial Acumen

Data-Driven Decision Making

Cross-Functional Collaboration

Stakeholder Engagement

Innovation & Change Leadership

Education

Bachelor's degree in Life Sciences

Advanced degree (MBA, MPH, MHA, PharmD, PhD, or equivalent)

Job description

The Director, Market Access, Reimbursement & Policy is a strategic leadership role responsible for advancing payer coverage, reimbursement, and patient access across Agendia's portfolio of precision oncology solutions.

This individual will lead the development and execution of market access strategies that support commercial growth, evidence adoption, and long-term reimbursement objectives. Working across Commercial, Medical Affairs, Clinical Development, Revenue Cycle Management, Government Affairs, and Executive Leadership, the Director will ensure market access considerations are integrated into corporate strategy and product lifecycle planning.

The ideal candidate combines deep expertise in payer policy, reimbursement strategy, molecular diagnostics, and healthcare policy with the ability to influence both internal and external stakeholders in an evolving healthcare environment.

POSITION WITHIN THE ORGANIZATION

• Reports to Sr. VP, Reimbursement & Gov’t Affairs
• Cooperates with all departments
• Cross-functional projects and meetings
• Risk assessments and audits

ESSENTIAL DUTIES AND RESPONSIBILITIES

Strategic Market Access Leadership

• Develop and execute comprehensive market access strategies that support the growth and adoption of Agendia's precision oncology portfolio.
• Identify opportunities and risks related to reimbursement, payer policy, coding, and healthcare regulations.
• Provide strategic guidance to leadership on market access trends, competitive dynamics, and reimbursement developments.
• Support access planning for new products, evidence-generation initiatives, and commercial expansion opportunities.
• Coverage, Reimbursement & Payment Strategy
• Lead initiatives designed to optimize payer coverage, coding, and reimbursement outcomes.
• Assess payer medical policies, utilization management requirements, and reimbursement trends to identify opportunities for improved patient access.
• Partner with Revenue Cycle Management and Commercial teams to address reimbursement barriers and improve payer performance.
• Support coding, pricing, and payment strategies, including CPT®, PLA, and CLFS-related initiatives.
• Evaluate reimbursement data and payer performance to drive strategic access improvements.
• Evidence & Policy Strategy
• Collaborate with Medical Affairs and Clinical teams to align evidence-generation priorities with payer evidence requirements.
• Translate clinical utility, analytical validity, and health economic evidence into compelling value propositions for payers and policy stakeholders.
• Provide market access perspective on publications, studies, presentations, and evidence-development strategies.
• Monitor legislative, regulatory, and policy developments impacting precision oncology, molecular diagnostics, and personalized medicine.
• External Stakeholder Engagement
• Build and maintain strategic relationships with commercial health plans, Medicare stakeholders, laboratory benefit managers, policy organizations, and professional societies.
• Represent Agendia in payer discussions, advisory boards, industry meetings, and market access forums.
• Support engagement with CMS, Medicare Administrative Contractors, and other governmental stakeholders.
• Serve as a trusted subject matter expert on reimbursement, market access, and payer policy.
• Cross-Functional Leadership
• Lead and influence cross-functional initiatives designed to support market access objectives and business growth.
• Deliver strategic insights that inform clinical, commercial, and corporate decision‑making.
• Partner with Commercial teams to support customer education related to access, reimbursement, and payer policy.
• Foster alignment across internal stakeholders to advance key business priorities.

The above listing represents the general duties considered essential functions of the job and is not to be considered a detailed description of all the work requirements that may be inherent in the position.

KEY CONTACTS

Internal: Works closely with finance, reimbursement, sales, compliance

External: Interacts with existing and potential clients, vendors as well as internal company departments

EDUCATION AND EXPERIENCE REQUIREMENTS

EDUCATION

• Bachelor's degree in Life Sciences, Healthcare Administration, Public Health, Health Policy, Business, or a related discipline.

EXPERIENCE

• 8+ years of progressive experience in market access, reimbursement, managed care, healthcare policy, health economics, or related healthcare functions.
• Experience within molecular diagnostics, genomics, oncology, biotechnology, laboratory medicine, or precision medicine.
• Strong understanding of U.S. commercial and government reimbursement systems, coverage policy development, and payer decision‑making processes.
• Demonstrated ability to influence senior stakeholders and lead complex cross‑functional initiatives.
• Exceptional strategic, analytical, communication, and presentation skills.

Specific Knowledge Required:

Knowledge: Comprehension of a body of information acquired by experience or study.

Skill: A present, observable competence to perform a learned activity.

Ability: Competence to perform an observable behavior.

• Advanced degree (MBA, MPH, MHA, PharmD, PhD, or equivalent).
• Experience supporting precision oncology, genomic testing, or personalized medicine products.
• Familiarity with Medicare, CMS, MolDx, commercial payers, and laboratory benefit managers.
• Experience in health economics, outcomes research, evidence‑generation strategy, or payer policy development.
• Expansion of favorable payer coverage and access across key commercial and government payer segments.
• Advancement of reimbursement strategies that improve payment performance and reduce systemic access barriers.
• Influence on payer policy, evidence generation, and stakeholder engagement initiatives that support long‑term market adoption.
• Development of strategic partnerships with payers, laboratory benefit managers, policy leaders, and other key healthcare stakeholders.
• Delivery of actionable market access insights that inform business strategy, product planning, and evidence‑development priorities.
• Leadership of cross‑functional initiatives that enhance the value proposition and long‑term commercial success of Agendia's genomic testing solutions.

BEHAVIOURAL COMPETENCIES/DESIRED SKILLS

• Strategic Leadership
• Executive Presence & Influence
• Market Access & Reimbursement Expertise
• Business & Financial Acumen
• Data-Driven Decision Making
• Cross‑Functional Collaboration
• Stakeholder Engagement & Relationship Building
• Innovation & Change Leadership
• PRIVACY NOTICE: To review the California privacy notice, click here: https://agendia.com/privacy-policy/
• Employees must not be classified as an excluded individual who is prohibited from participation in any Federal health care program.

WORKING ENVIRONMENT

Establishes ADA (Americans with Disabilities Act) requirements

ENVIRONMENT/SAFETY/WORK CONDITIONS

• General office environment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Maintains a clean, neat, and orderly work area.
• Adheres to Department Specific Safety Guidelines.
• Standing, sitting, walking, bending, reaching, manual manipulation, and lifting up to 15 pounds.