National Market Access Manager
Core
Lead national and regional managed care contracting, negotiate payer contracts, and resolve reimbursement disputes to optimize revenue for organ transplant testing products.
Role type
Senior Market Access Manager (Managed Care Contracting)
Builds
National and regional contracts with third-party payors (Medicare, Medicaid, commercial plans)
Domain
Healthcare / Molecular Diagnostics / Organ Transplant
Deliverable
client delivery
Required skills
Managed care contracting, contract negotiation, payer reimbursement methodology, regulatory compliance analysis, data analysis, project management, MS Excel proficiency
Preferred skills
Master's degree, experience with multiple state payors, familiarity with WC/Auto/Medicaid/CMS products
Technologies
MS Excel, SAS, Xifin billing system
Responsibilities
Lead 3rd party payer contract negotiations and discussions; Develop and maintain a contracting strategy aligned with market trends; Analyze contracts and financial terms to determine re-negotiation needs; Lead payer petitioning for coverage decisions; Interface with internal departments (Billing, Finance, Legal, Analytics); Create third-party tools for payor policy databases and fee schedules; Monitor regulatory requirements and contract language; Perform data analysis to measure product effectiveness and ROI.
Seniority
Senior, hands-on IC with team leadership
