Senior Manager / Associate Director, Payer Policy and ...

Job Title: Senior Manager / Associate Director, Payer Policy and Reimbursement OptimizationLocation: Onsite – Chicago, IL. Job Type: Permanent, Full-TimeCompensation: $120,000 – $160,000 Base Salary AnnuallyBonus: Manager Level: 10–15% | AD/Director Level: 15–20%Position OverviewThe (Sr. Manager/Associate Director) of Payer Policy and Reimbursement Optimization will play a pivotal role in driving payer engagement, defining clinical and economic value, and aligning reimbursement strategies to support broader adoption of advanced diagnostic technologies. This individual will serve as a critical liaison between Market Access, Revenue Cycle Management (RCM), Clinical, Medical Affairs, and Commercial teams, supporting initiatives that enable access and value-based coverage.Key ResponsibilitiesDevelop and articulate the clinical, economic, and quality-of-life value proposition of the product portfolio to payer stakeholders.Collaborate with internal teams to create robust publication plans, economic models, evidence dossiers, and payer education programs.Build and maintain relationships with payer organizations and key decision-makers, including technology assessment bodies and professional societies.Partner with RCM to support reimbursement operations including prior authorizations, appeals, and payer inquiries.Lead the development of value-based evidence generation strategies, including pilot programs and population health initiatives.Monitor and evaluate payer policies impacting products and provide actionable insights.Author high-quality scientific documents, manuscripts, and policies supporting reimbursement efforts.Represent the company at payer meetings, conferences, and strategic engagements to present clinical and health economic data.Serve as the clinical/scientific liaison to ensure aligned messaging across payer, commercial, and marketing teams.Qualifications5+ years of direct experience with payers in developing and implementing medical policies for advanced diagnostics or companion diagnostics.Advanced healthcare degree required (PhD, PharmD, RN, MS, CGC, or similar).Deep understanding of revenue cycle processes, including prior authorization and appeals.Demonstrated success developing payer-facing scientific content and value messaging.Strong understanding of precision medicine, especially in CNS oncology.Experience in project management related to clinical trials or payer demonstration projects.Exceptional scientific writing and communication skills.Ability to travel up to 30%.Established relationships with payers and HTA organizations strongly preferred.Prior experience in a dynamic, high-growth healthcare organization is a plus.Personal and Professional AttributesHigh integrity with a commitment to confidentiality.Effective team leader and collaborator, with strong interpersonal skills across all organizational levels.Exceptional written and verbal communication skills.Highly analytical with a proactive approach to problem-solving.Adaptable to fast-paced environments with shifting priorities.Strong organizational skills and attention to detail.Technologically proficient in Microsoft Office Suite and relevant health care or data systems.

Created: 2025-06-03