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Associate Director, Health Economic Outcomes Research & Payer Policy

  • United States
  • Full Time

About the Job

The Associate Director, Health Economic Outcomes Research and Payer Policy supports the payer relations and reimbursement team by working directly with payers and payer-related organizations, building scientific/clinical relationships with internal and external stakeholders, and furthering the reimbursement effort by collating existing data and informing the development of new data to support initial and ongoing coverage and reimbursement of Foundation Medicine’s Product Portfolio.

Key Responsibilities

•        Present the clinical/scientific aspects of the Foundation Medicine product line to payers and payer stakeholders in collaboration with payer team partners.

•        Partner with Payer Account Director(s) to develop and execute account-specific strategies to advance coverage of FMI products and position FMI as a valued partner in the laboratory space.

•        Engage with Laboratory Benefit Management and Health Technology Assessment organizations (e.g. BCBSA Evidence Street, ECRI, AIM, etc.) to increase the positive assessments of Foundation Medicine testing.

•        Engage both internal and external stakeholders to inform the generation of evidence supporting the use of current and future FMI products.

•        Be responsible for clinical and scientific content of communications and documents directed toward payers and the broader reimbursement audience to increase positive coverage determinations for FMI products.

•        Serve as a subject matter expert in the review of payer market access materials

•        Take on and complete specific tasks related to payer projects, including but not limited to, payer “pilots” or demonstration projects.

•        Travel regionally up to 20% of the time.

•        Other projects as assigned.


Basic Qualifications

•        Bachelor’s Degree from a 4-year institution

•        7+ years of experience in the healthcare industry

Preferred Qualifications

•        Advanced Health Care degree (e.g. PhD, PharmD, MS, CGC)

•        Experience writing manuscripts, medical policies, dossiers, etc.

•        Previous experience working with payers to review, draft and implement policies supporting coverage and payment for advanced molecular diagnostics, and/or companion diagnostic products (i.e. precision or personalized medicine)

•        Established relationships with payers, laboratory benefit management organizations, and/or health technology assessment organizations

•        Ability to understand and clearly articulate advanced medical/scientific concepts (e.g., cancer genomics) at a level where they can be effectively understood by payers

•        Exceptional written and verbal communication capabilities

•        Passion for contributing to a transformation in cancer care – strong drive, sense of initiative and commitment to mission

•        Understanding of HIPAA and importance of privacy of patient data

•        Commitment to FMI values: patients, innovation, collaboration, and passion

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