Managed Care Director
Remote, N/A, United States
Company Description
Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary tests, vast data sets and advanced analytics. The Guardant Health oncology platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. Guardant Health has commercially launched Guardant360®, Guardant360 CDx, Guardant360 TissueNext™, Guardant360 Response™, and GuardantOMNI® tests for advanced stage cancer patients, and Guardant Reveal™ for early-stage cancer patients. The Guardant Health screening portfolio, including the Shield™ test, aims to address the needs of individuals eligible for cancer screening.
Job Description
The Director of Managed Care is responsible for developing and executing a strategically targeted Regional account plan for building coverage, contracting & revenue pull-through with California Independent Physician Associations.
Essential Duties and Responsibilities:
- Manage all IPA related activities with regional accounts with the potential to manage National accounts as the business expands.
- Develop contacts and relationships throughout large insurance organizations and IPA’s.
- Influence key players to drive to specific business objectives
- Set strategy, analyze and assess both qualitative and quantitative contract data, and negotiate medical policy and contracts for Guardant as an in-network provider.
- Work collaboratively with our Sales, Sales Management, Reimbursement Operations, and Finance teams and will bring market knowledge to present clinical data to accounts but also partner with our Medical Affairs team for policy development.
- Knowledge of important sales territory-related issues and the evolving healthcare landscape, and can pilot opportunities in evolving markets (i.e. Employer, ACO).
Qualifications
- Extensive experience in the molecular diagnostics market (previous NGS experience a plus) or related experience is required
- 5+ years Managed Care medical policy development and contracting and sales experience within the Health Care Industry.
- Experience within the California managed care reimbursement business setting and have experience developing and executing on a California focused reimbursement plan aligned to sales and revenue objectives for cancer molecular testing.
- Strong understanding of the complexity of payer contracting and have a track record of successful partnerships with some of the top IPA’s and have numerous Regional plan relationships that you can leverage in this role.
- Demonstrated success at partnering with various channels (employers, ACO) to bring a higher level of expertise into planning for these markets.
- Demonstrated track record in driving favorable reimbursement with IPA’s or commercial payers.
- Established relationships with or reliable access to key National and Regional MCO stakeholders …
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Hybrid work model Must be onsite on specific days
Benefits/PerksFlexible Work Schedule Hybrid work Hybrid work model Onsite collaboration Work-from-home days Work-life balance
Tasks- Collaborate with sales and finance teams
- Negotiate contracts
Analytics Clinical Data Collaboration Contracting Data analysis Diagnostics Education Flexibility Healthcare Healthcare policy Managed Care Market knowledge Medical Affairs Molecular diagnostics Molecular Testing Negotiation Oncology Operations Reimbursement Reimbursement strategies Relationship Management Sales Training
Experience5 years
EducationB.A. B.S. Business Finance MBA
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9