CND Life Sciences
Manager, Market Access Strategy and Operations
CND Life Sciences, Scottsdale, Arizona, us, 85261
Overview
Manager, Market Access Strategy and Operations. The Manager, Market Access Strategy and Operations is responsible for driving the execution and optimization of CND's payer strategies, contract operations, and reimbursement workflows to support commercial growth and ensure financial sustainability. Reporting to the VP of Market Access, this individual will serve as a critical cross-functional leader, collaborating with RCM, Patient Access, Finance, Sales, Clinical Services and Medical Affairs to achieve revenue and access targets through payer contracting, analytics, and operational excellence.
Responsibilities
Lead or support negotiation, implementation, and management of managed care contracts to ensure alignment with corporate goals. Serve as the primary contact for assigned payers and networks; build and maintain strong relationships with current and prospective contracted entities. Influence payer coverage by aligning clinical, economic, and strategic value messaging to support favorable policy decisions and reimbursement outcomes. Analyze contract terms, identify gaps, and drive amendments or renewal strategies as needed. Recommend improvements to optimize revenue and reduce costs through data-driven insights. Translate strategic objectives into measurable quarterly and annual goals, including reporting on KPIs such as payer engagement, revenue realization, and coverage gains. Support field teams in overcoming payer objections and advancing favorable coverage. Liaise with hospital contracting teams to support evaluation and execution of facility-based agreements. Support strategies to engage employers, hospitals, and health systems to create new reimbursement channels and expand patient access. Represent CND in industry events and access forums to gather insights and strengthen payer strategy. Monitor payer policy trends, pricing shifts, legislation, and competitive dynamics. Collaborate with Patient Access, RCM, and Finance to address underperforming payers and refine reimbursement strategies with leadership. Assist in the development of materials to support payer engagement, coverage discussions, and broader market access initiatives. Support audit readiness and ensure documentation of contracting and access workflows. Contribute to the development and standardization of SOPs for contract and reimbursement operations.
Knowledge, Skills & Experience
Minimum 5–8 years of experience in diagnostics, biotech, life sciences, or healthcare services, with a focus on market access operations, payer contracting, or reimbursement. Proven experience managing managed care contracts, building payer relationships, and driving revenue optimization strategies, including efforts to influence coverage decisions. Strong knowledge of the U.S. healthcare payer landscape, including Medicare, commercial plans, hospitals, and employer groups, with an understanding of how to align internal value messaging with payer expectations to support coverage. Familiarity with laboratory billing practices, fee schedules, and coding/reimbursement policies (e.g., MolDX, MACs, LCD/NCD processes). Strong knowledge and understanding of healthcare product development and commercialization. Demonstrated experience using Salesforce, CRM tools, and business intelligence platforms (e.g., Power BI, Excel). Strong strategic thinking, attention to detail, and the ability to distill complex contract issues into actionable plans. Experience leading small teams or complex, cross-functional initiatives a plus.
Education, Certifications, and Licensures
Bachelor's degree in a relevant field such as Health Policy, Business Administration, Economics, Public Health, or Life Sciences OR In lieu of a Bachelor's degree, a minimum of 7–10 years of progressively responsible experience in market access, payer contracting, reimbursement operations, or healthcare revenue cycle will be considered. Preferred: Master's degree (MBA, MPH, MHA, or related).
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Finance and Sales Industries: Medical and Diagnostic Laboratories
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Manager, Market Access Strategy and Operations. The Manager, Market Access Strategy and Operations is responsible for driving the execution and optimization of CND's payer strategies, contract operations, and reimbursement workflows to support commercial growth and ensure financial sustainability. Reporting to the VP of Market Access, this individual will serve as a critical cross-functional leader, collaborating with RCM, Patient Access, Finance, Sales, Clinical Services and Medical Affairs to achieve revenue and access targets through payer contracting, analytics, and operational excellence.
Responsibilities
Lead or support negotiation, implementation, and management of managed care contracts to ensure alignment with corporate goals. Serve as the primary contact for assigned payers and networks; build and maintain strong relationships with current and prospective contracted entities. Influence payer coverage by aligning clinical, economic, and strategic value messaging to support favorable policy decisions and reimbursement outcomes. Analyze contract terms, identify gaps, and drive amendments or renewal strategies as needed. Recommend improvements to optimize revenue and reduce costs through data-driven insights. Translate strategic objectives into measurable quarterly and annual goals, including reporting on KPIs such as payer engagement, revenue realization, and coverage gains. Support field teams in overcoming payer objections and advancing favorable coverage. Liaise with hospital contracting teams to support evaluation and execution of facility-based agreements. Support strategies to engage employers, hospitals, and health systems to create new reimbursement channels and expand patient access. Represent CND in industry events and access forums to gather insights and strengthen payer strategy. Monitor payer policy trends, pricing shifts, legislation, and competitive dynamics. Collaborate with Patient Access, RCM, and Finance to address underperforming payers and refine reimbursement strategies with leadership. Assist in the development of materials to support payer engagement, coverage discussions, and broader market access initiatives. Support audit readiness and ensure documentation of contracting and access workflows. Contribute to the development and standardization of SOPs for contract and reimbursement operations.
Knowledge, Skills & Experience
Minimum 5–8 years of experience in diagnostics, biotech, life sciences, or healthcare services, with a focus on market access operations, payer contracting, or reimbursement. Proven experience managing managed care contracts, building payer relationships, and driving revenue optimization strategies, including efforts to influence coverage decisions. Strong knowledge of the U.S. healthcare payer landscape, including Medicare, commercial plans, hospitals, and employer groups, with an understanding of how to align internal value messaging with payer expectations to support coverage. Familiarity with laboratory billing practices, fee schedules, and coding/reimbursement policies (e.g., MolDX, MACs, LCD/NCD processes). Strong knowledge and understanding of healthcare product development and commercialization. Demonstrated experience using Salesforce, CRM tools, and business intelligence platforms (e.g., Power BI, Excel). Strong strategic thinking, attention to detail, and the ability to distill complex contract issues into actionable plans. Experience leading small teams or complex, cross-functional initiatives a plus.
Education, Certifications, and Licensures
Bachelor's degree in a relevant field such as Health Policy, Business Administration, Economics, Public Health, or Life Sciences OR In lieu of a Bachelor's degree, a minimum of 7–10 years of progressively responsible experience in market access, payer contracting, reimbursement operations, or healthcare revenue cycle will be considered. Preferred: Master's degree (MBA, MPH, MHA, or related).
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Finance and Sales Industries: Medical and Diagnostic Laboratories
Referrals increase your chances of interviewing at CND Life Sciences by 2x
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr