Person, Text, Face

Payer Relations Account Director – Northwest

  • United States
  • Full Time

About the Job

The Payer Relations Account Director works with Regional and National Health Plans focused in the Northwest. This position functions in a strategic, highly visible leadership position responsible for the identification, development, and management of strategic relationships with payers and organizations that influence payer decision-making. With minimal supervision, this individual is responsible for obtaining coverage and reimbursement of the entire FMI portfolio within their assigned accounts. The incumbent enables access to testing that makes a difference for payers and providers and the patients they serve.  

Key Responsibilities

•        Assist the Vice President of Payer Relations & Reimbursement to set strategic vision for assigned payer targets, assist with payer related medical policy coverage, negotiate, secure, and manage pull through of new and existing contracts with appropriate Health Plans. Contracts can also include, other managed care organizations (MCOs), value-based agreements, health systems, employers or other government payers that lead to access of care.

•        Establish a strong working relationship with payer customers throughout the health plan organization and healthcare ecosystem and arrange for payer meetings to discuss value of products and partnerships for their members.

•        Develop National and Regional Account plans; conduct appropriate financial analyses and consider impact of applicable regulatory requirements.

•        Work collaboratively with counterparts with sales leaders, clinical teams, billing, legal, and marketing personnel on strategic business development efforts to ensure coverage, access, and reimbursement of products.

•        Interact with senior management and/or multiple decision-makers to conclude a positive coverage policy and/or contract negotiation.

•        Serve as liaison between payer customers and company personnel on administrative matters.

•        Work in collaboration with field sales leaders to aid in training and co-promoting the FMI portfolio in their assigned accounts. Participate actively in the preparation and execution of regional field sales plans.

•        Generate forecasts to determine projected return based on coverage and contracts; including estimates of utilization to management, as well as estimates of market potential by product/service/geographic area.

•        Provide feedback to appropriate company personnel regarding payer customer needs and feedback to contract offerings and service.

•        Demonstrate strong working relationship with customers throughout the health plan organization and arrange for payer customer meetings internally and externally.

•        Keep abreast of the payer industry; regulatory, scientific, medical, operational, and marketing plans - incorporating into a strategic approach.

•        Represent company at trade shows, scientific or other conferences.

•        Analyze payer customers’ near-term and longer-range needs and requirements promotes - consideration of new or refined company services to meet such requirements.

•        Assist in segmentation of customers and willingness to enter into new markets that enables access and reimbursement to services.

•        Engage and partner with all stakeholders within the health care ecosystem to provide education and ensure access to testing services including (but not limited to) KOL's, employers, LBM's, associations, local ASCO chapters, and patient advocacy groups.

•        Approximately 25 - 30%  field and meeting travel required, pending COVID.

•        Other duties as assigned.


Basic Qualifications

•        Bachelor's degree

•        8+ years of experience within Payer/National Accounts and/or Corporate Accounts in oncology and/or laboratory testing

Preferred Qualifications

•        Advanced degree or healthcare certification(s) a plus

•        Extensive experience (12+) in Oncology, Diagnostic and/or healthcare industry

•        Knowledge and a proven track record in Oncology and Laboratory testing

•        Experience and a proven track record with Health Plans both in the private and government sector including coverage policy, contracting, and pull-through

•        Demonstrated relationships with key payer decision-makers and influencers

•        Demonstrated success with consistent achievement above defined goals & objectives

•        A proven track record of success with special projects and difficult selling scenarios including, but not limited to, adoption of disruptive technologies or transformative products or services

•        Experience and a proven track record with personalized medicine products or services is a plus

•        Demonstrate the ability to work effectively with cross-functional teams in a fast-paced, multi-dimensional organization

•        Strong project management and negotiation skills

•        Ability to take initiatives and act independently exercising strong business judgement within the scope of the role

•        Must demonstrate highly refined analytical and communication skills and the ability to work effectively both independently and in a team environment

•        Understanding of HIPAA and the importance of patient data privacy

•        Commitment to reflect FMI’s values: Patients, Collaboration, Innovation, and Passion


#LI-Remote [Cambridge, Massachusetts, United States]


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.

Apply Now

Internal applicants, please use your FMI email address.

Please let me know about more jobs like this

Not You?

Thank you

Recommended Jobs

Customer Experience Executive (Central Region)

Client Services 100654 United States United States Client Services
About the Job The Customer Experience Executive (CEE) within the Customer Experience team partners directly with a subset of current, key FMI accounts serving as a single point and liaison of contact for pre-, peri-, and post-testing. The positio...

Director, Digital Lab Innovation

Lab Operations 100821 Cambridge Massachusetts United States Second Street, Cambridge, Massachusetts, United States Operations
About the Job The Director of Digital Laboratory Innovation is a passionate, creative, enterprise-minded leader responsible for building a strategic plan and driving the implementation of key digital technology initiatives as part of our Technolo...

Scientist I, Research & Early Development

Research and Early Development 100775 San Diego California United States Towne Centre Ct., San Diego, California, United States R&D
About the Job The Scientist I role is part of the Research and Early Development team in FMI’s Product Development group. This position explores new technologies and biomarker candidates to address unmet needs in the oncology field. The position ...

Competitive Intelligence Intern (Graduate)

Strategic Insights, Analytics and Enablement 100619 United States United States Global Portfolio Strategy
About the Job The Intern, Competitive Intelligence supports the Strategic Insights & Analytics team. The team is responsible for providing competitive and strategic insights across FMI (Commercial, Biopharma, Data, Medical, R&D and Operat...
Sitting, Person, Finger, Computer, Electronics, Pc, Reading
Text, Person, Baby, Handwriting, Finger, Diaper, Wood
Person, Building, Factory, Clothing, Apparel, Manufacturing, Lab

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)

To all recruitment agencies: Foundation Medicine does not accept agency resumes. Please do not forward resumes to our jobs alias, Foundation Medicine employees or any other organization location. Foundation Medicine is not responsible for any fees related to unsolicited resumes.