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1. Research and identify which healthcare insurance policy from CMS, private payers (United Healthcare, Anthem Blue Cross Blue Shield, Aetna, Cigna, Kaiser Permanente) are most likely to cover OTC rapid diagnostic tests. 2. Develop and execute reimbursement strategies for Genabio’s products: (a) OTC Rapid Tests (b) Glucose Meters and Test Strips (c) POC CLIA-waived Rapid Tests 3. Create detailed step-by-step roadmaps to achieve coverage under Medicare, Medicaid (multi-state), and private insurers for each product category, including: - Required documentation - Submission timelines 4. Coordinate coding, billing, and reimbursement strategies: - Secure appropriate CPT/HCPCS/NDC codes - Develop payer dossiers, prior authorization tools, and billing templates 5. Manage the EUA-to-510(k) transition for COVID-19 test kits: - Evaluate use of shared GTIN/NDC across EUA and 510(k) versions - Mitigate risks around brand name change (Genabio → GenaCheck) - Align Medicaid billing systems for uninterrupted reimbursement 6. Serve as subject matter expert for all payer-related communications and documentation 7. Lead PBM formulary application and contracting efforts for eligible OTC products 8. Collaborate cross-functionally with regulatory, commercial, and legal teams to ensure compliance and access alignment Qualifications: Bachelor’s degree in Health Policy, Public Health, Life Sciences, or related field; Master’s preferred. 5+ years of experience in diagnostics, medical device, or pharmaceutical reimbursement. Demonstrated experience obtaining Medicare, Medicaid, and PBM coverage for OTC or home-use tests. Strong working knowledge of coding systems (CPT, HCPCS, NDC), billing practices, and payer engagement strategy. Familiarity with DME reimbursement pathways and FDA EUA/510(k) transitions. Strong project management, cross-functional communication, and analytical skills. Preferred Qualifications: - Experience with Medicaid coverage strategy across multiple states. - Prior success working with PBMs and retail pharmacies on formulary inclusion. - Exposure to payer negotiation, economic modeling, or value-based access initiatives. 401(k) Health insurance Vision insurance Paid time off Seniority level

Seniority level Mid-Senior level Employment type

Employment type Full-time Job function

Job function Finance and Sales Industries Medical Equipment Manufacturing Referrals increase your chances of interviewing at Genabio Diagnostics by 2x Sign in to set job alerts for “Reimbursement Manager” roles.

Greater Boston $106,000.00-$178,000.00 3 weeks ago Director of Strategic Accounts (Northeast)

Waltham, MA $190,000.00-$240,000.00 1 week ago Account Executive - $2500 Sign-on Bonus || $7500 in Rental Assistance || Relocation Assistance

Customer Success Manager: Medical Devices

Customer Success Manager - Medical Devices

Medical Staff Peer Review/Risk Manager 40 hours/week 8am-4:30pm $5,000 sign on bonus!

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Cambridge, MA $202,500.00-$292,500.00 5 days ago Senior Manager, Payer Relations and Market Access

Boston, MA $143,900.00-$237,600.00 3 weeks ago Director Clinical Documentation Integrity

Beverly, MA $71,668.00-$89,585.00 3 weeks ago Marlborough, MA $129,673.89-$216,123.16 1 month ago Provider Operations Revenue Cycle - Manager

Boston, MA $99,000.00-$232,000.00 2 weeks ago Manager, Medical Group Optimization, Compensation Advisory Healthcare Consulting

Boston, MA $150,000.00-$176,000.00 1 month ago North Andover, MA $40.00-$52.00 3 days ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.

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