Senior Manager, Pricing & Contracting

Overview

A growing genetics testing organization is expanding its market access and payer account engagement capabilities. The team has extensive experience in hospital settings and is rapidly growing in outpatient settings with new test offerings. The organization seeks to achieve coverage and reimbursement for genetic testing with commercial health plans and government payers to provide patients and clinicians with important clinical insights.

They are hiring a Senior Manager, Pricing & Contracting to partner with Channel Directors in Managed Care and Medicaid to expand in-network contracts with payers and provide key pricing analytics. This is a full-time role focused on analyzing proposed contract terms with payers to understand financial terms and contract commitments.

Responsibilities

• Support the Vice President of Market Access and Channel Directors with contract development, pricing models, bid processes, health system management, and business strategies
• Model financial risks and opportunities related to major pricing proposals
• Collaborate cross-functionally to maintain accurate customer contracts and pricing, incorporating these into financial models
• Prepare and present pricing reports to senior management, market access teams, and cross-functional partners
• Work with the Access Strategy team to perform pricing analyses on ad-hoc projects and evaluate new product opportunities
• Develop and manage pricing databases, software, and tools with cross-functional partners
• Evaluate the impact of pricing changes on sales and margins
• Identify and recommend improvements to contracting processes to meet evolving business needs
• Identify appropriate data sources for pricing and reimbursement information related to payers and genetic tests
• Use descriptive and advanced analytics methods to generate actionable insights from large datasets
• Track reimbursement rates, fee schedules, and associated CPT codes for payers and test codes
• Build effective relationships with team members, clients, and cross-functional partners, influencing directly and indirectly
• Demonstrate results orientation, strong initiative, and a sense of urgency to drive issues to closure
• Adapt positively to change and operate effectively in a dynamic environment
• Maintain excellent organizational skills and attention to detail
• Ensure compliance with company policies, guidelines, and code of conduct
• Perform other job-related duties as assigned

Requirements

• Bachelor's degree required
• 5+ years of relevant business experience, or advanced degree, or professional certifications
• Proficient in Microsoft Office, especially Excel
• Experience with data analytics in the life sciences industry
• Experience with pricing analytics and insights for contracting purposes
• Experience reporting pricing insights to senior management
• Knowledge of CPT coding as it relates to laboratory testing pricing is preferred
• Familiarity with third-party data resources and fee schedules for U.S. payers (CMS, Medicare, Medicaid, Commercial Health Plans)
• Understanding of the U.S. payer payment system
• Ability to manage projects and work effectively as an individual contributor in a cross-functional environment
• Intellectual curiosity and strong problem-solving skills
• Ability to deliver results according to deadlines and project plans
• Experience with genomics and genetics is preferred

Physical Demands and Work Environment

• Frequently required to sit, stand, use hand and finger dexterity, talk, hear, and utilize visual acuity for equipment operation and reading technical information
• Occasionally exposed to bloodborne and airborne pathogens or infectious materials

Location

Details about the work location were not specified.