Senior Manager / Associate Director, Market Access & Reimbursement

Cleveland Diagnostics is a fast-growing biotechnology company developing next-generation diagnostic platforms, focusing on cancer diagnostics. The Senior Manager / Associate Director of Market Access and Reimbursement is responsible for refining and executing commercial coverage strategies to secure coding, coverage, and payment from public and private payers, ensuring broad patient access to their diagnostic technologies.

Responsibilities:

• 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)
• 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
• 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

Requirements:

• 10+ years healthcare industry experience
• 7+ years in reimbursement and market access, with a strong preference for diagnostics experience in the oncology field
• Bachelor's degree or advanced degree in related field
• Prior success in market access across both LDT or IVD products
• Deep understanding of HEOR, managed care, and health policies
• Proven ability to thrive in ambiguous environments
• Strong communication skills, demonstrated ability to work cross-functionally, and internal relationship-building
• Advanced degree such as MBA
• Experience with advanced diagnostics, point-of-care, or oncology tools