Director, Market Access - Great Lakes

GeneDx (Nasdaq: WGS) delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable precision medicine as the standard of care. GeneDx is at the forefront of transforming healthcare through its industry-leading exome and genome testing and interpretation services, fueled by the world’s largest, rare disease data sets. For more information, please visit www.genedx.com. 

Summary   

The Market Access Director – Great Lakes will grow existing and develop new GeneDx payor relationships across the Great Lakes region, including select National Payors and Lab Benefit Managers (LBMs). The Director will secure favorable payor contracts, expand medical policy coverage for exome and genome sequencing, develop strategic payor partnerships, and serve as the voice of the payor at GeneDx. Your strategic efforts will shape our market presence and success by expanding patient access to a genetic diagnosis.   

Job Responsibilities 

• Develop innovative access, pricing, coverage and contracting strategies to support the needs of patients and their clinicians, that ultimately drive business growth, profitability and performance   

• Lead payor contracting strategy within the assigned geography/payors by identifying opportunities to obtain new contracts and/or improve rates and terms in existing contracts with regional payors, national payors, Managed Medicaid (MCOs), Lab Benefit Managers (LBMs), etc.   

• Drive the expansion of payor medical policies, conveying the latest evidence and guidelines to payor accounts, focusing on exome and genome sequencing.   

• Collaborate with cross-functional teams, including Revenue Cycle Management (RCM), Legal, Training, Sales, and Marketing, aligning efforts for successful contract implementation.   

• Guide the RCM team on changing payor requirements that may impact reimbursement success.   

• Provide subject matter expertise in the following areas: professional society guidelines, health technology assessments, relevant published evidence, lab benefit management programs, medical policies, state legislation, and other regulations and market trends that may have business impact.   

• Proactively share insights based on payor data and drive solutions to address opportunities to improve reimbursement success.   

• Provide strategic Market Access guidance to the GeneDx field sales team within the assigned geography to achieve volume and revenue targets.   

• Identify and develop opportunities for strategic payor partnerships that will further the GeneDx position as a market leader in genomics.   

• Establish partnerships with external stakeholders such as advocacy groups, health systems, state legislators, and key opinion leaders who may help accelerate policy change efforts.   

• Serve as the payor-expert, advising internal business leads across your geography and beyond, based on your deep knowledge of the current and future payor landscape.   

• Solve complex business problems on behalf of GeneDx, leveraging internal and external resources to devise effective solutions  

 People Manager  

• No  

Education, Experience, and Skills 

• 10+ years of Market Access experience, preferably in molecular diagnostics   

• 5+ years of experience in genomics is strongly preferred   

• Demonstrated experience with indirect networks, including IPAs   

• Demonstrated experience managing a large national payor, such as UnitedHealthcare  

• Bachelor’s degree or higher in related field    

• Proven track record of influencing payor medical policies    

• Strong executive presence with a solution-oriented mindset   

• Demonstrated ability to simplify and communicate complex information    

• Strong analytical, communication, and interpersonal skills   

• Highly adaptable in a rapidly changing environment           

• Ability to travel for business-critical meetings (up to 20% of the time)  

 Work Environment  

• This is a fully remote position. The employee will work from a home office or other suitable remote location with reliable high-speed internet access. Work is performed in a climate-controlled environment using standard office equipment including computer, phone, and video conferencing tools. Your standard work schedule and hours will be established in collaboration with your leader and may be adjusted to align with evolving business needs. 

#LI-REMOTE