Director of Reimbursement and Market Access
BillionToOne is looking for Director of Reimbursement and Market Access who will lead BillionToOne's reimbursement strategies to enable access of our products to millions of expecting parents.
The Director of Reimbursement and Market Access drives medical policy coverage initiatives, and contracting strategies within Government, Commercial Payors, Managed Care Organizations, and employer groups. This role will be a foundational member of the Commercial team and be responsible for developing and executing reimbursement strategies with public and private healthcare plans to ensure the broadest possible access to BillionToOne’s products. The Director of Reimbursement and Market Access will report to the Vice President of Sales and Commercial Operations.
If you have experience in market access and/or contracting and thrive in a fast-paced, entrepreneurial environment this could be a great opportunity for you.
- Develop and implement Market Access strategies for BillionToOne products, with Government and Commercial Payors, including value proposition, reimbursement, coding and contracting.
- Lead contracting and negotiations with payors to optimize patient access to BillionToOne’s portfolio.
- Oversee, help prepare, and ensure timely submission and processing of credentialing applications.
- Put in place processes that enable compliant processing of claims & denial management.
- Monitor and influence reimbursement trends to obtain and ensure the best coverage-coding-payment combination.
- Develop and maintain relationships with Government and Commercial payors to obtain positive coverage decisions that include adequate payment.
- Stay up to date on trends in the managed care market and develop strategy with senior management to address the changes and maintain highest possible reimbursement rates.
- Prepare, coordinate and manage contract negotiation process.
- Prepare responses to Request for Proposals (RFP).
- Assist field representatives with reimbursement challenges.
Who You Are:
- Bachelor’s degree in business, marketing, or related field.
- 5+ years of experience in any of the following areas: contracting and coverage with large national payors, government, medical group contracting, device or diagnostic laboratory companies, or extensive experience working in health plan contracting.
- Extensive knowledge of reimbursement programs in laboratory services and testing.
- Reimbursement contracting and coverage experience, preferably in prenatal molecular testing.
- Possess a solid understanding of the prenatal testing market: reimbursement, products, companies and technology.
- Demonstrated track record of developing and managing complex negotiations with multiple decision makers.
- Existing relationships with individuals at commercial insurance companies, MediCal, and group payor organizations.
- Ability to develop a value proposition and effective business case that will influence medical policy.
- Prior experience in start-ups.
More About Us:
BillionToOne has developed noninvasive prenatal tests for the most common genetic disorders in the world. More than 100 million people are carriers for these disorders. The prenatal detection of these disorders currently requires invasive methods with high miscarriage risk, but we have developed tests that solve this important problem.
BillionToOne has recently raised a large Series A funding from global institutional investors, including from Hummingbird Ventures, NeoTribe Ventures and Y Combinator:
Check out a simplified introduction to our technology and its potential to transform molecular diagnostics:
We offer highly competitive salary and benefits combined with a truly generous equity package. You will be working on interesting problems with extremely high-impact.
BillionToOne is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.