BioLink 360Remote
Market Access/Pricing/Reimbursement Manager-Diagnostics
United States of America
Full Time
10 hours ago
$125,000 - $200,000 USD
Visa Sponsor
Key skills
Reimbursement programsUS market access strategyDiagnosticsPrecision medicineCompanion diagnostic productsPayer requirements for coveragePayer coverage processesPayer reimbursement considerationsPayer policyCPT codingHCPCS codingCMS payment systemsPayer engagementCoding systemsPayment methodologiesPayer policy processesCoverage decision-making frameworksClaims data analysisCoding roadmapsCoverage strategiesPayment modelingPFS payment methodologyOPPS payment methodologyAPCs payment methodologyLCD developmentNCD developmentProject managementProject Management
About this role
BioLink 360 is an advisory firm within the precision medicine space, seeking a Market Access Leader with expertise in securing coding, coverage, and payment for laboratory diagnostics. The role involves developing and executing reimbursement strategies, collaborating with clients, and analyzing regulations to shape market access solutions.
Responsibilities:
- Assume ownership of workstreams with minimal supervision and draft client-ready deliverables, ensuring timeliness and professional quality
- Collaborate with internal and external teams to align reimbursement strategy with regulatory, market access, and commercial objectives
- Instrumentalize research and analysis to identify risks, policy implications, and strategic considerations for clients and external stakeholders
- Analyze government regulations, proposed/final payment rules, and coverage/policy updates
- Conduct comprehensive reviews of CMS, MAC, and commercial payer policies, legislative proposals, and coding/payment updates (e.g., CPT®, HCPCS, ICD-10, DRG)
- Analyze claims data, policy documents, and payment files to identify trends and implications for client strategy
- Develop coding roadmaps, coverage strategies, and payment modeling to support client product launches and lifecycle management
- Provide guidance on coding applications (CPT®, HCPCS Level II), payment rate-setting methodologies (PFS, OPPS, APCs), and coverage pathways (LCD/NCD development, commercial payer adoption)
Requirements:
- Bachelor's degree required; advanced degree (MPH, MHA, MBA, MPP, MS Health Economics, or similar)
- 5+ years of experience with reimbursement programs and US market access strategy initiatives for diagnostics, precision medicine or companion diagnostic products
- Knowledge of payer requirements for coverage, payer coverage processes/timelines, payer reimbursement considerations, and existing payer policy
- Understanding of coding systems, payment methodologies, payer policy processes, and coverage decision-making frameworks
- Excellent project management skills, able to execute multiple client deliverables under tight deadlines
- Exceptional attention to detail and commitment to producing high-quality, client-ready work
- Experience with CPT/HCPCS coding, CMS payment systems, and payer engagement is highly desirable