Overview Salary up to $108,290 Hybrid work model offering flexibility for better work-life balance Opportunity for career advancement and growth within the organization Supportive and collaborative work environment Chance to influence reimbursement policies that enhance patient access to innovative diagnostics Responsibilities Lead analysis of payer coverage policies, identifying trends, gaps, and opportunities across Medicare, Medicaid, and commercial payers Provide strategic recommendations to influence payer coverage criteria for advanced diagnostics Oversee complex appeals and serve as an escalation point for challenging payer denials and external reviews Collaborate with internal teams to strengthen rebuttals and ensure clinically robust submissions Represent the employer in payer, policy, and clinical forums as a subject matter expert Qualifications 5-7+ years of experience in healthcare reimbursement, clinical payer policy, or related fields Demonstrated success engaging with commercial and government payers Strong understanding of payer coverage frameworks, laboratory billing, and NGS reimbursement Proven expertise in clinical documentation, appeal writing, and payer policy interpretation Exceptional communication, writing, and presentation skills for payer and regulatory audiences Preferred Qualifications Advanced degree preferred (MS, MPH, CGC, MSN, PharmD, MD, or equivalent); clinical background strongly valued Proficiency with Excel and data analysis tools; familiarity with payer portals and laboratory billing systems a plus Strong leadership, organizational, and problem-solving skills #PrecisionOncology #HealthcareReimbursement #CareerOpportunity #HybridWorkModel #PatientAccess We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer. #J-18808-Ljbffr Remote Jobs
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