Cleveland Diagnostics (CDx) is a fast-growing, venture-backed, commercial-stage biotechnology company developing next-generation diagnostic platforms and products, such as our proprietary IsoClear platform and our first product, IsoPSA for prostate cancer. We operate in a high-intensity, agile environment where clinical impact meets cutting-edge technology. Our mission is to bring actionable clarity to the diagnosis and treatment of complex diseases, such as cancer, and we envision a future where disease derived insight guides every major care decision.
Job Title
Senior Manager / Associate Director, Market Access & Reimbursement
Reports To
The Senior Manager / Associate Director, Market Access & Reimbursement will report to the Chief Commercial Office
Job Overview
The Senior Manager / Associate Director of Market Access and Reimbursement will refine and execute on the commercial coverage strategy for CDx's diagnostics portfolio and secure coding and favorable coverage and payment from public and private payers. Activities will range from the tactical (e.g., credentialing) to the strategic (e.g., payor targeting to contracting). This role ensures the widest possible patient access to our technologies by proving their clinical and economic value.
Key Responsibilities & Duties
Strategic Reimbursement Planning
- Refine coverage, coding, and payment strategies for existing and new products for both public and private payors.
- Secure unique CPT, PLA, or ICD-10 diagnostic codes as needed.
- Create and refine compelling, evidence-based payor value dossiers and other marketing materials for public and private payers.
- Align clinical trial endpoints to address payer evidence requirements, including cost effectiveness modeling and clinical utility studies.
- Work with CDx Billing to analyze market and payor trends, broad policy changes, and other reimbursement dynamics (e.g., reimbursement landscape for competitive products).
Payer Engagement & Advocacy
- Build relationships with medical directors at regional and national commercial health plans, as well as at Medicare Administrative Contractors (MACs).
- Present clinical and economic data to secure positive coverage policies.
- Partner with health economics firms to build cost-effectiveness models.
- Work with CDx Marketing to mobilize patient advocacy groups and clinicians to support coverage.
Cross-Functional Support & Compliance
- Advise CDx R&D and Clinical teams on clinical utility study design.
- Along with CDx Billing and our reimbursement consultants, monitor changes among
- Work with CDx Billing to train internal sales teams on billing and prior authorization processes.
- Coordinate with CDx Sales leadership to inform team as to new coverage policies and contracting developments that are locally important to CDx account executives and their key accounts.
- Ensure all market access activities meet healthcare compliance standards.
Required Qualifications
- Experience: 10+ years healthcare industry experience. 7+ years in reimbursement and market access, with a strong preference for diagnostics experience in the oncology field.
- Education: Bachelor's degree or advanced degree in related field.
- Domain Expertise: Prior success in market access across both LDT or IVD products. Deep understanding of HEOR, managed care, and health policies.
- Startup Agility: Proven ability to thrive in ambiguous environments.
- Other: Strong communication skills, demonstrated ability to work cross-functionally, and internal relationship-building.
Preferred Qualifications
- Advanced degree such as MBA
- Experience with advanced diagnostics, point-of-care, or oncology tools.
Physical Requirements/ Working Conditions/Equipment Used:
- Ability to: sit, stand and/or walk throughout course of day; operate a computer and multitask across many software communication and data entry programs while operating and communicating through telephone device for several hours a day.
Other Requirements
- This is a remote position
Cleveland Diagnostics, Inc., is developing highly efficacious, lab-friendly, affordable diagnostics tests using proprietary technology to improve cancer diagnostics. Its portfolio of non-invasive diagnostics will be expanding from prostate cancer to breast cancer and lung cancer. We pride ourselves in fostering a family-focused, friendly, and flexible organization that places our employee's well-being and happiness as the primary reason for our success. Are you interested in building your career with a team of industry professionals while making a lasting impact to the lives of millions of people? Bring your talents to Cleveland Diagnostics.
Cleveland Diagnostics offers an extremely robust benefits package which includes:
- 100% Employer-paid medical for single coverage effective on your date of hire and 50% employer-paid medical for spouse/dependent coverage
- 100% Employer-paid Dental & Vision for entire family
- No cost for employee coverage for Group Term Life, Short & Long Term Disability
- 4% retirement contribution Employer match
- Incentive Performance Plan & Stock Option Program & Commission (Sales Account Execs)
- Paid Family Leave Program
- Generous PTO plan & holiday program
- Flexible work schedule & lucrative employee referral program
- Salary range may vary by work state/geographical region/territory
- Easy to get to office location with newly built-out office space
- Free coffee, snacks and other goodies all day long
Cleveland Diagnostics is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because that is what drives curiosity, innovation, and the success of our business. EEO is the Law. Applicants can learn more about the company's status as an equal opportunity employer by viewing the federal EEO is the Law poster on our careers page. Accommodations are available for applicants with disabilities.
Compensation details: 85000-150000 Yearly Salary
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