Sr. Director, Payer Reimbursement & Pricing

Foundation Medicine, Inc.

Full Time

About the Job

The Senior Director Payer Reimbursement and Pricing position involves assessing existing portfolio and new products reimbursement dynamics and commercial and government payer requirements to sustain and grow reimbursement for the Foundation Medicine product line. The position involves analyzing the competitor and CMS pricing and coding, to inform key reimbursement strategy components. This role also involves monitoring and assessing coding and pricing dynamics, collaborating with various departments including Payer Relations & Reimbursement (PRR), Market Access & Policy (MAP), Product, Clinical Development, Revenue & Access, and Sales and Marketing, in developing reimbursement strategies that reflect the company's goals.

This highly skilled individual will be able to manage the complex landscape of molecular diagnostics reimbursement throughout the different products lifecycle. The ideal candidate will combine strategic insight with a detailed understanding of coding, billing, and data analytics to optimize revenue and ensure compliance. This workstream leader is responsible for leading coding initiatives that will support premium pricing of our products within the Payer team pricing responsibility for Foundation Medicine. A key function of this role is to identify Medicare, Medicaid and Commercial Payer requirements, and create implementation strategies to support Foundation Medicine's Revenue Cycle Management functions. Job scope includes credentialing and re-credentialing Payers and Payer contract management. This role requires a visionary business leader, creative relationship builder, and strategic thinker who can ascertain what is needed to keep FMI ahead of the market.

This business growth-oriented leader, as a member of the Payer Leadership Team (PLT), will report to the VP HEOR, Market Access and Payer Strategy.

Key Responsibilities

• Perform thorough coding and pricing market landscape and competitor analyses on existing similar products to inform proper price positioning.
• Perform thorough market landscape and competitor dynamic analyses to inform the optimal pipeline product reimbursement pathways strategy.
• Develop and inform strong analytical plans defining the willingness-to-pay requirements of the government and key commercial payers.
• Master both the art and science of product pricing that incorporates the product attributes, competitive positioning and customer perceived value.
• Build fact-based pricing models supported with reliable-sourced market data, partner with new product launch team and act as the Voice-Of-Payer (VOP) in building the new product coding and pricing strategies.
• Communicate effectively the pricing proposals to relevant functions and gain timely buy-in.

Qualifications

Basic Qualifications

Preferred Qualifications

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About Foundation Medicine

Confidence, or the belief that we need to check every box before applying for a job, can sometimes hold us back from going after a role that inspires us. At Foundation Medicine there's no such thing as the 'perfect' applicant, and our company is a place where every employee can make an impact and continue to grow whatever background they may have or path they may have taken. So, as long as you meet the basic qualifications for a role, please apply if you see a position that would make you excited to come into Foundation Medicine every day and help us transform cancer care.

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