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

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

• Full-time

Eurofins Scientific is an international life sciences company, providing a unique range of analytical testing services to clients across multiple industries, to make life and our environment safer, healthier and more sustainable. From the food you eat, to the water you drink, to the medicines you rely on, Eurofins works with the biggest companies in the world to ensure the products they supply are safe, their ingredients are authentic and labelling is accurate.

Eurofins is the global leader in food, environment, pharmaceutical and cosmetic product testing and in agroscience Contract Research Organisation services. Eurofins is one of the market leaders in certain testing and laboratory services for genomics, discovery pharmacology, forensics, advanced material sciences and in the support of clinical studies, as well as having an emerging global presence in Contract Development and Manufacturing Organisations. The Group also has a rapidly developing presence in highly specialised and molecular clinical diagnostic testing and in-vitro diagnostic products.

In over just 30 years, Eurofins has grown from one laboratory in Nantes, France to 55,000 staff across a decentralised and entrepreneurial network of 900 laboratories in over 50 countries. Eurofins offers a portfolio of over 200,000 analytical methods to evaluate the safety, identity, composition, authenticity, origin, traceability and purity of biological substances and products.

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
• Monitors, escalates and summarizes potentially problematic contract provisions and regulatory issues to management as it relates to payer contracting
• Interfaces with internal departments such as Payor Enrollment, Revenue Cycle, Analytics, Finance, Quality Management, and Legal
• Develops and maintains relationships with operational counterparts at payors and regulatory bodies nationally
• Works with external legal counsel to investigate and evaluate national and state payor market regulatory statutes
• Assists with the development and maintenance of department policies and standard operational procedures, in collaboration with underlings on the Payor Relations’ department, ensuring compliance
• Creates third‑party tools to create a Payor policy database specific to the tests Eurofins performs
• Creates a dynamic fee schedule/reimbursement matrix and database
• Resolves payor related reimbursement and contract language interpretation issues
• Seeks and finds increased revenue opportunities through claims investigation, analysis of billing patterns/interfacing with billing and payer contractual non‑compliance
• Performs 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
• Models and runs payment analysis reports in Excel and other modeling programs from SAS data downloadable from our Xifin billing system
• Monitors, identifies, summarizes and maintains a repository of applicable regulatory and contractual requirements (i.e. No Surprise Bill state legislation, Medicare/Medicaid required contract language etc.)
• Serves as a project manager for any directed projects
• Understands and investigates as needed, and disseminates 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

Essential Knowledge, Skills and Abilities

• Bachelor degree in Business Administration, Finance, Accounting and/or Information Systems required
• Master’s Degree preferred
• Ability to lead a team of diverse skill‑sets and age groups
• Strong interpersonal skills; strong written, verbal and analytical skills; ability to adhere to deadlines; work to get the job done “right the first time”
• Minimum 10 years healthcare administrative experience
• Must be a self‑starter with the ability to organize and multi‑task multiple tasks/projects to completion
• Professional business sense; strong knowledge of payor reimbursement methodology types
• Proficient in creating and utilizing MS Excel spreadsheets and all other MS Office programs, business intelligence tools, and/or other reportable performance programs
• Experience working with multiple state payors preferred
• Ability to process and understand complex information related to working in a managed care environment
• Strong familiarity with managed care terminology and managed care contact provisions
• Experience in compiling, coordinating, and analyzing payor contract regulatory requirements and contract language
• Ability to maintain high level of confidentiality regarding sensitive corporate data
• Ability to work outside core business hours as needed and take ownership of issue‑resolution regardless of hours worked

Physical Requirements

• Physical dexterity sufficient to use hands, arms, and shoulders repetitively to operate a keyboard and other office equipment, use a telephone, access file cabinets and other items stored at various levels, including overhead
• Ability to speak and hear well enough to communicate clearly and understandably with sufficient volume to ensure an accurate exchange of information in normal conversational distance, over the telephone, and in a group setting
• Ability to continuously operate a personal computer for extended periods of time (4 or more hours)
• Mental acuity sufficient to collect and interpret data, evaluate, reason, define problems, establish facts, draw valid conclusions and make valid judgments and decisions
• Must be vaccinated against the novel COVID‑19 virus variants or provide proof of approved exemption

The essential physical and mental requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Schedule

• Monday-Friday, 8:00am-5:00pm

What we offer

• Excellent full‑time benefits including comprehensive medical coverage, dental, and vision options
• Life and disability insurance
• 401(k) with company match
• Paid vacation and holidays

Eurofins USA Clinical Diagnostics is a Disabled and Veteran Equal Employment Opportunity employer.

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