Description:
The Market Access Sales Associate Director drives medical policy coverage initiatives, contracting strategies and payer utilization programs within assigned national, regional and local payers. The position supports Market Access strategy and implementation on a national level, including new markets. Liaises with revenue cycle management and legal, and makes recommendations on billing, fee schedule maintenance and payer strategy. Calls on payer organizations that impact reimbursement nationally, selling products within payer quality and other utilization programs, develops coverage policy for new products, provides technical and administrative product information and responds to requests for proposals. Travel is required up to 50% within key US Markets, and Exact Sciences headquarters in Madison WI, to provide national support to drive cross-functional market access initiatives.
Essential Duties
Include, but are not limited to, the following:
- Manage complex national and regional payer contract negotiations. Work with cross-functional areas to create, finalize and maintain contracts with payers.
- Manage and deepen existing relationships with existing contracted insurance companies.
- Sell Exact Sciences testing to payers’ quality programs and other relevant areas within payers.
- Partner with field market leaders as the Market Access expert to inform the market strategy and guide priorities to exceed the forecast.
- Develop and implement strategies that lead to successful acceptance of Exact Sciences testing into payer medical policy guidelines.
- Maximize reimbursement by negotiating the highest possible reimbursement rates for Exact Sciences testing.
- Stay up to date on trends in the commercial payer and Medicaid market and develop strategy with senior management to address the changes and maintain acceptable reimbursement rates.
- Assess potential legal risk in the context of contract provisions; prepare letters of agreement and key contract provisions.
- Initiate and develop relationships and track history and progress.
- Serve as the principal contact with the select large commercial payers managing contracting and pull through with quality managers.
- Assist field representatives with reimbursement challenges, partner with sales training and sales force effectiveness.
- Attend conferences and physician meetings related to payers and provide expertise to the Market Access team and internal stakeholders.
- Take responsibility to coordinate coverage designations for preventive medicine and Exact Sciences products.
- Act in a leadership capacity for the Market Access team working closely with headquarters teams to develop and implement customer strategies and monitor projects supporting field pull through of account wins, collaborating closely with the functional VPs and the Market Access Strategy leadership.
- Ability to work independently with little direction.
- Capacity to research and stay current on managed care and healthcare industry trends.
- Effective English communication skills, both written and verbal.
- Effective presentation skills; ability to speak confidently to all levels of an organization and present ideas to customers in a way that produces understanding and impact.
- Outstanding influencing, interpersonal, and networking skills to drive successful relationship building.
- Outstanding problem solving, project, and program management skills.
- Apply effective time management, expense reporting, prioritization, and delegation skills.
- Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork.
- Support and comply with the company’s Quality Management System policies and procedures.
- Maintain regular and reliable attendance.
- Ability to act with an inclusion mindset and model these behaviors for the organization.
- Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day.
- Ability to travel 50% of working time away from work location, may include overnight/weekend travel.
Minimum Qualifications
- Bachelor’s Degree in Business, Marketing, or related field.
- 8+ years of experience in any of the following areas: contracting and coverage with large national payers, medical group contracting, sales, sales leadership in biotech, device or diagnostic laboratory companies, or extensive experience working in health plan contracting, coverage or case management.
- Extensive knowledge of reimbursement programs in pharma, lab, biotech, and/or device.
- Possess a solid understanding of the molecular diagnostic testing market: products, companies, and technology.
- Demonstrated success developing and managing complex negotiations with multiple decision makers.
- Demonstrated success developing a value proposition and effective business case that will influence medical policy.
- Demonstrated ability to present clinical data, scientific findings, and complex information in a persuasive manner to a variety of audiences.
- Demonstrated ability to perform the essential duties of the position with or without accommodation.
- Authorization to work in the United States without sponsorship.