Sr. Manager of Market Access, Clinical Support

Sr. Manager of Market Access, Clinical Support

Join to apply for the Sr. Manager of Market Access, Clinical Support role at Veracyte, Inc.

At Veracyte, we offer exciting career opportunities for those interested in joining a pioneering team that is committed to transforming cancer care for patients across the globe. Working at Veracyte enables our employees to not only make a meaningful impact on the lives of patients, but to also learn and grow within a purpose-driven environment. This is what we call the Veracyte way – it’s about how we work together, guided by our values, to give clinicians the insights they need to help patients make life-changing decisions.

• We Seek A Better Way:
  We innovate boldly, learn from our setbacks, and are resilient in our pursuit to transform cancer care.
• We Make It Happen:
  We act with urgency, commit to quality, and bring fun to our hard work.
• We Are Stronger Together:
  We collaborate openly, seek to understand, and celebrate our wins.
• We Care Deeply:
  We embrace our differences, do the right thing, and encourage each other.

The Sr. Manager of Market Access will be an individual contributor role focused on supporting the clinical and medical policy-related aspects of Market Access and Reimbursement Operations initiatives to drive coverage and contracting efforts. This role will operate within the Market Access team but will collaborate closely with the Reimbursement leadership and other departments to support aspects of the operations requiring clinical and medical policy input.

Responsibilities include creating and updating content for appeal letters, writing personalized appeal letters tailored to individual patients’ medical histories, and participating in peer-to-peer/external review appeals for key scenarios.

Responsibilities will align with three focused areas:

• Partnering with Market Access, Medical Affairs, Marketing and Reimbursement leadership to optimize the appeals content necessary to support coverage and appeal efficacy initiatives.
• Be the key face of Veracyte in peer-to-peer and external review initiatives with a targeted list of payers to positively affect medical coverage policies for Veracyte’s portfolio of testing.
• Lead the creation and management of content such as dossiers, presentations, etc. needed to support coverage and contracting initiatives with payors and Laboratory Benefit Managers (LBMs).

• In collaboration with cross-functional teams, support the development of content leveraging clinical, scientific, and health economic data, targeted to key healthcare decision-makers responsible for making medical policy and/or coverage decisions at health insurance companies and LBMs as needed.
• Support engagement with Healthcare Practitioners and patient advocates to reinforce coverage/contracting initiatives.
• Participate in Market Access, Reimbursement Operations, and other cross-functional team meetings.
• Update and maintain appeals content in response to changes to payer medical policies, State Biomarker laws, and general healthcare trends.
• Requires monitoring and tracking changes to relevant medical policies.
• Create customized appeals content specifically targeted to strategic coverage and contracting opportunities identified as needed.
• Plan, execute, and participate in peer-to-peer and external review appeals.
• Initiate, track, and report submissions to state departments of insurance regarding complaints or disputes of non-covered claims.
• Conduct the necessary research and detailed review of patient medical records to determine if medical necessity criteria were met and craft personalized appeal letters demonstrating the clinical value of our services for individual patients as needed.

We require this position to have a clinical background. The ideal candidate would be a physician, nurse, genetic counselor, or medical science liaison with clinical experience and experience in overturning coverage decisions in peer-to-peer conversations with insurers. The person will be highly respected, maintain collegial relationships with peers, and be a creative thinker who enjoys developing novel approaches to…