Director of Market Access at Millennium Health responsible for managing payer relationships and optimizing market access strategies. Engaging in collaboration with sales leadership to drive business growth.
Responsibilities
Support development of strategy and prioritization for managed care contracting in collaboration with Senior Director and Senior Vice President of Market Access
Assist the contract development process from insurer contract proposals through final approval including deal structure, analysis, forecasting and reporting of contract profitability
Establish collaborative working relationship with sales leadership and their teams to inform and guide market access strategies, key target identification, and optimal opportunities for synergistic value creation
Maintain competitive, contracted in-network reimbursement rates for Millennium Health and identify and pursue opportunities to improve rates that are below market
Identify and pursue opportunities with contracted accounts to expand into additional business lines offered by the payer
Develop and expand Millennium Health’s relationships across contracted payer functions, including executive leadership, medical policy, contracting, risk management, compliance, etc.
Demonstrate ability to personally maintain relationships with, and influence, key payer decision makers
Leverage payer relationships to support Millennium Health objectives, including audit prevention and defense, exploration of Millennium Health data program(s) partnering, and other strategic initiatives to enhance Millennium Health’s value to the payer and to the company’s business
Collaborate closely with Millennium Health functional leadership, contracting Consultants, finance team, billing department, analytics executives, legal counsel and key customers
Manage existing insurer contracts to ensure continuity, successful renewal and renegotiate fee schedules where appropriate to achieve revenue optimization.
Capable of supporting the Market Access team through engagement in policy and advocacy-related work (e.g., ACLA, CCLA, CAHP, MGMA)
Capability in conducting basic financial analyses to inform strategies and prioritization
Develop internal and external partnerships to enable funding, reimbursement and access, which can include guidelines, innovative financing or payment models, and public health programs
Monitor contract performance process to quantify the profitability of Managed Care programs and help develop strategies and tactics for remediation of underperforming contracts, working directly with the Senior Director of Market Access
Work with contracted insurers, sales leadership, and marketing to manage and implement successful redirection and other collaborative pull-through-related programs
Partner with all cross-functional stakeholders to align on priorities and resourcing for business objectives across all areas of the enterprise
Willingness to participate in basic management needs of the department (e.g., state payer lists, redirection curation, contract reviews, etc.)
Ability to think strategically regarding the value of Market Access for Millennium and advancement and advocacy of the purpose and value of drug testing itself
Ability to ensure HIPAA, Confidentiality and Compliance policies, procedures, and standards are always adhered to.
Ability to ensure administrative, physical and technical cybersecurity controls are always adhered to.
Regular and reliable attendance
Requirements
Bachelor’s Degree in Business, Science or related field required
Master’s Degree encouraged
Five years of progressive leadership experience in Market Access contracting, policy development or similar responsibility with a health services, device, or pharmaceutical company; related laboratory experience preferred
Significant personal experience of successfully selling/advocating directly to payer organizations and influencing payer decision makers
Documented experience in managing the negotiation process for contracts and/or contract maintenance with major health insurance companies
Excellent communication, inter-personal and negotiation skills
Networking and relationship development skills
Strong analytical, quantitative, and qualitative analysis skills required
Ability to influence without authority
Existing network of payer relationships
Blend of strategic and tactical skills
Demonstrated consistent follow-through and creative persistence with payer stakeholders
Compelling presentation skills
Strong computer software skills including in depth working knowledge of Microsoft Office applications
Willingness and ability to travel extensively throughout the US and to MH corporate headquarters in San Diego
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