National Market Access Director - Monday-Friday, 8:00am-5:00pm position at Eurofins.| United States Of America

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Eurofins National Market Access Director - Monday-Friday, 8:00am-5:00pm

Experience: General

Pattern: Full-time

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Associate

Lenexa, Kansas....United States Of America

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Job DescriptionTransplant Genomics Inc. (“TGI”) is a molecular diagnostics company committed to improving organ transplant outcomes with non-invasive serial monitoring guided by biomarkers. TGI’s product portfolio of both individual and combined whole blood gene expression and donor derived cell-free DNA testing is capable of reliably ruling out subclinical kidney rejection and acute rejection in kidney transplant patients. In addition to kidney transplantation testing, our newest product for liver transplant patients is a blood-based biomarker assay designed to rule out rejection as immunosuppression therapy is optimized.Director, National Market Access (“Director”) will partner with and report to the VP of Market Access or Finance Leader and communicate regularly with the Director of Billing. The Director will be responsible for managing and supporting the administrative and internal operational aspects of the managed care contracting department on a regional and national level. This position would serve as a conduit between Billing, Payor Relations credentialing and enrollment functions and third-party payors, including Medicare and Medicaid programs, to resolve issues related to reimbursement, language, and other disputes to create revenue optimization. If requested, the Director will fulfill these same functions for other Eurofins third party billing businesses.Essential Job Duties and Responsibilities: • Leads all 3rd party payer contract negotiations and all other contract related discussions with payers • Develops, drives and maintains a contracting strategy for the organization that is cognizant of current market trends and aligns incentives among companies within the Eurofins network of companies • Manages and negotiates national and regional contracts to ensure companies’ objectives are met in a timely manner. • Analyzes applicable contracts, associated documents and proposed fees, and negotiates financial terms of contracts • Analyzes existing terms to determine if re-negotiation is warranted • Leads payer petitioning endeavors to overturn negative coverage decisions, or to ensure positive coverage decisions for new tests • Serves as the companies’ primary business owner and conduit for each 3rd party payer • Serves as designated participant on Executive Leadership team for clinical companies with third party billing requirements • Monitor, escalate and summarize potentially problematic contract provisions and regulatory issues to management as it relates to payer contracting. • Interface with internal departments such as Payor Enrollment, Revenue Cycle, Analytics, Finance, Quality Management, and Legal. • Develop and maintain relationships with operational counterparts at payors and regulatory bodies nationally. • Work with external legal counsel to investigate and evaluate national and state payor market regulatory statues. • Assist with the development and maintenance of department policies and standard operational procedures, in collaboration with underlings on the Payor Relations’ department, ensuring compliance. • Creation of third-party tools to create a Payor policy database specific to the tests Eurofins performs. • Creation of a dynamic fee schedule/reimbursement matrix and database. • Resolve payor related reimbursement and contract language interpretation issues. • Seek and find increased revenue opportunities through claims investigation, analysis of billing patterns/interfacing with billing and payer contractual non-compliance. • Perform data analysis from a variety of data sources to evolve the metrics used to measure effectiveness and return on investment of all current and new product activity. • Model and run payment analysis reports in Excel and other modeling programs from SAS data downloadable from our Xifin billing system • Monitor, identify, summarize and maintain a repository of applicable regulatory and contractual requirements (i.e. No Surprise Bill state legislation, Medicare/Medicaid required contract language etc.). • Serve as a project manager for any directed projects. • Understand and investigate as needed, and disseminate, information to the managed care contracting department and billing, operations and sales of any new WC, Auto, Medicaid, CMS or health plan products introduced into the market place.

National Market Access Director - Monday-Friday, 8:00am-5:00pm job opportunity at Eurofins.

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