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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Expertise in Medicare reimbursement strategies, including NCDs, LCDs, and coding processes, with a strong focus on genomic sequencing and genetic testing. Proven ability to influence federal health policy and collaborate across multiple departments to shape national reimbursement policy.
Highest-signal resume keywords
Medicare Reimbursement StrategiesGenomic Sequencing ExpertiseCMS Coverage Policy KnowledgeStakeholder EngagementPolicy Analysis
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medicare CoverageReimbursement MethodologiesCPT CodingPLA CodingNCDsLCDsMolDxFederal Health PolicyMarket Access StrategiesPrecision Medicine
Soft Skills
Executive CommunicationInfluencing SkillsCollaboration
Certifications & Qualifications
Bachelor's DegreeAdvanced Degree Preferred
Industry Keywords
CMSMedicare Administrative ContractorsClinical AffairsRegulatory AffairsHealth Economics and Outcomes Research
About the role
Key responsibilities & impact- Lead Medicare market access strategies for genomic sequencing and genetic testing
- Develop strategies for NCDs, LCDs, MolDx, MAC engagement, CLFS pricing, CPT/PLA coding, and reimbursement
- Monitor CMS rulemaking and federal reimbursement policy developments
- Partner with Government Affairs on federal advocacy and policy initiatives
- Collaborate with Medical Affairs and HEOR to develop evidence supporting Medicare coverage
- Represent the company with CMS, Medicare contractors, and industry organizations
- Serve as the company's primary expert on CMS coverage policy, Medicare Administrative Contractors, coding processes, reimbursement methodologies, and federal regulatory developments affecting genomic sequencing and genetic testing
- Work with Government Affairs, Medical Affairs, HEOR, Clinical Affairs, Regulatory Affairs, and Commercial teams to shape national reimbursement policy
Requirements
What you’ll need- Bachelor's degree required; advanced degree preferred (MPH, MHA, PharmD, PhD, JD, MBA, or equivalent)
- 10+ years of experience in Medicare reimbursement, federal health policy, or market access
- Experience leading Medicare coverage and reimbursement strategies for genomic sequencing, genetic testing, molecular diagnostics, precision medicine, or other advanced diagnostic technologies
- Over 5 years of direct experience working with CMS, Medicare Administrative Contractors (MACs), MolDx, or other Medicare reimbursement and policy organizations
- Demonstrated success influencing Medicare coverage, coding, pricing, or reimbursement policy
- Deep knowledge of NCDs, LCDs, CLFS, CPT and PLA coding, gapfill and crosswalk pricing, and Medicare payment policy
- Excellent policy analysis, stakeholder engagement, and executive communication skills
- Approximately 25–35% travel
- This role is not eligible for visa sponsorship
Benefits
Comp & perks- Variable cash program (bonus or commission)
- Equity for eligible roles
- Access to genomics sequencing
- Family planning benefits
- Health, dental, and vision benefits
- Retirement benefits
- Paid time off
- Employee Resource Groups offering career development experiences, cultural awareness, and social responsibility opportunities