Market Access Manager - Midwest

US-WI-Madison | US-IL-Chicago | US-MN-Minneapolis | US-MI-Detroit | US-IN-Indianapolis | US-OH
Req No.
2017-1951
Category
Sales
Type
Regular Full-Time

Summary of Major Responsibilities

The Market Access Manager drives medical policy coverage initiatives, and contracting strategies within assigned regional managed care organization(s), and employer groups (employee benefit plans).  Calls on managed care organizations developing coverage policy; provides technical and administrative product information and responds to requests for proposals.  Travel is required at least 50-60% within region and at requested times, outside of incumbent’s region to provide national support.

Essential Duties and Responsibilities

  • Contract with major insurance companies and group payer organizations. Manage complex contract negotiation and work with cross functional departments to bring the contracting process to closure.
  • Manage existing relationships with existing contracted insurance companies.
  • Develop and implement strategies that lead to successful acceptance of Exact Sciences testing into payer medical policy guidelines.
  • Maximize reimbursement by negotiating the highest possible reimbursement rates.
  • Stay up to date on trends in the managed care market and develop strategy with senior management to address the changes and maintain acceptable reimbursement rates.
  • Prepare, coordinate and manage contract negotiation process.
  • Identify and evaluate opportunities and financial terms for MCOs, GPOs, IPAs and other healthcare systems.
  • Assess potential legal risk in the context of contract provisions. Prepare letters of agreement and key contract provisions.
  • Identify and target specific market segments for development, including key payers, employers or other managed care organizations.
  • Initiate and develop relationships, track history and progress.
  • Serve as the principal contact with the payers, employers and providers in development and review of proposed agreements within assigned territory.
  • Prepare responses to Request for Proposals (RFP).
  • Assist field representatives with reimbursement challenges.
  • Attend conferences and physician meetings.

Qualifications

Minimum Requirements

 

•    Bachelors of Sciences Degree or equivalent. 
•    5 years of managed care contracting and reimbursement experience, preferably in molecular diagnostics or life sciences.
•    Able to work independently with little direction, capacity to research and stay current on managed care and healthcare industry trends.
•    Possess a solid understanding of the molecular diagnostic testing market: products, companies and technology.
•    Best, demonstrated track record of developing and managing complex negotiations with multiple decision makers.
•    Outstanding problem solving, project and program management skills.
•    Ability to develop a value proposition and effective business case that will influence medical policy.
•    Ability to present clinical data, scientific findings and complex information in a persuasive manner to a variety of audiences.
•    Proven, effective time management, expense reporting, prioritization and delegation skills.
•    Effective English communication skills, both written and verbal
•    Outstanding influencing, interpersonal and networking skills to drive successful relationship building.
•    Effective presentation skills; able to present ideas to customers in a way that produces understanding and impact.
•    Must be willing to travel at least 75% within designated region and some travel outside of region as needed for national leadership meetings
•    Must possess a valid driver's license, have no more than 2 moving violations in the past 36 months, and have no unresolved revocation or suspension issues.

Desired Characteristics
•    Minimum 2-3 years MCO contract management responsibility required.  
•    Experience in one or more of the following industries required:  medical device, health care, or insurance.  
•    Existing relationships with individuals at insurance companies and group payer organizations
•    Strong presentation skills and the ability to speak confidently to all levels of an organization required.

LI-AS1

 

Exact Sciences is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, creed, disability, gender identity, national origin, protected veteran status, race, religion, sex, sexual orientation, and any other status protected by applicable local, state or federal law. The Company’s affirmative action program is available to any applicant or employee for inspection upon request. 

If you need any assistance seeking a job opportunity at Exact Sciences, or if you may require a reasonable accommodation with the application process, please call our Recruitment Coordinator at 608-535-8841 or email jobs@exactsciences.com.

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