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Associate Director, Health Outcomes & Payer Policy

  • United States
  • Full Time

About the Job

The Associate Director, Health Outcomes and Payer Policy supports the payer relations and reimbursement team by working directly with payers and payer-related organizations, building scientific and 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 Accounts Team to develop and execute account-specific strategies to advance coverage and reimbursement 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 and operationalize payer requirements for reimbursement.
  • Engage both internal and external stakeholders to inform the generation of evidence supporting the use of current and future FMI products.
  • Collaborate with internal Health Economics and Outcomes Research team on projects and evidence generation.
  • 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 marketing and value proposition materials.
  • Take on and complete specific tasks related to payer projects, including but not limited to, payer “pilots” or demonstration projects.
  • Travel up to 30% of the time.
  • Other projects as assigned.

Qualifications

Basic Qualifications

  • Bachelor’s Degree
  • 7+ years of experience in the healthcare industry

Preferred Qualifications

  • Advanced Health Care degree (e.g. PhD, PharmD, MS, CGC)
  • Experience working with health plans or in oncology diagnostics
  • 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)
  • Proficient with MS Office (e.g. Work, Excel and PowerPoint)
  • CRM proficiency: Salesform.com beneficial
  • 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
  • Ability to prioritize and make effective decisions
  • Ability to work independently with minimal supervision
  • Proven negotiation skills working with contracts and key customer processes
  • Proficient in analyzing and interpreting data
  • Strategic and critical thinker
  • Excellent verbal and written communication skills
  • Effective presentation skills
  • 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

#LI-Remote

 

Please be aware that Foundation Medicine mandates COVID-19 vaccination of all employees regardless of work location. Accommodations may be made in accordance with applicable law.

 

About Foundation Medicine

Foundation Medicine, Inc. (FMI) began with an idea—to simplify the complex nature of cancer genomics, bringing cutting-edge science and technology to everyday cancer care. Our approach generates insights that help doctors match patients to more treatment options and helps accelerate the development of new therapies. Foundation Medicine is the culmination of talented people coming together to realize an important vision, and the work we do every day impacts real lives.

Confidence, or the belief that we need to check every box before applying for a job, can sometimes hold us back from going after a role that inspires us. At Foundation Medicine there's no such thing as the 'perfect' applicant, and our company is a place where every employee can make an impact and continue to grow whatever background they may have or path they may have taken. So, as long as you meet the basic qualifications for a role, please apply if you see a position that would make you excited to come into Foundation Medicine every day and help us transform cancer care.

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Internal applicants, please use your FMI email address.

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Foundation Medicine is proud to be an Equal Opportunity and Affirmative Action employer and considers all qualified applicants for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin. Further, qualified applicants will not be discriminated against on the basis of disability or protected veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. See also FMI’s EEO Statement and EEO is the Law and Supplement. If you have a disability or special need that requires accommodation, please let us know by completing this form.  (EOE/AAP Employer)

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