What You Can Expect
Conducts analytical work to support Market Access strategies and payer submissions. Supports the development and execution of payer strategies through data analysis, monitoring payer trends, and assisting with escalated case resolution, bridging operational execution and strategic insight.
How You'll Create Impact
- Analyzes payer and reimbursement data to identify market trends and insights.
- Develops materials supporting payer engagement and reimbursement submissions.
- Collaborates with cross-functional teams on access and pricing projects.
- Drafts summaries and reports communicating key findings to stakeholders.
- Maintains current knowledge of payer policy and formulary updates.
- Assists in preparing business cases and evidence packages for payer negotiations.
- Ensures compliance with internal processes and regulatory requirements.
- Contributes to the refinement of tools, models, and templates for market access analyses.
- Monitor claims data and identify situations where CD Laboratories may want to contract with third-party payers
- Monitor claims data and identify negative payer coverage and claims processing issues, identifying methods of resolution and needed advocacy
- Assist with payer contract negotiations, providing recommendations for appropriate contract terms and fee schedule allowances
- Assist with oversight of CD Laboratories claims processing, ensuring efficient and compliant claims processes
- Lead resolution process for payer coverage and denial issues
What Makes You Stand Out
- Understanding of payer decision-making processes and pricing dynamics.
- Analytical skills for interpreting reimbursement and access data.
- Ability to communicate findings effectively across teams.
- Knowledge of policy and regulatory frameworks influencing market access.
- Strong planning and coordination skills.
- Initiative and accountability in project execution.
Education and Experience
- Bachelor's Degree and 2 years of relevant experience, or Associate's Degree and 4 years of relevant experience, or High School Diploma or Equivalent and 6 years of relevant experience
- Bachelor's degree in healthcare administration, health insurance, nursing or related field is preferred
- 2 years of experience in market access, reimbursement, payer relations, or healthcare analytics is preferred
Travel Expectations
Expected Compensation Range: $79,293 to $100k, plus target bonus
