GeneDx (Nasdaq: WGS) delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable precision medicine as the standard of care. GeneDx is at the forefront of transforming healthcare through its industry-leading exome and genome testing and interpretation services, fueled by the world’s largest, rare disease data sets. For more information, please visit www.genedx.com.

Senior Vice President of Payor Relations and Reimbursement

Payors have never been more important for our patients! As the senior vice president (SVP) of payor relations and reimbursement you will be responsible for the payor experience, driving the policy and reimbursement strategy, budget, and planning amidst a dynamic and growing landscape. In this role we will be relying on you to strengthen our relationship with payors while expanding access for our patients. As an SVP you will also be responsible for leading our market access and billing teams to successfully execute the payor strategy. This role will be a key member of the senior leadership team and report to the Chief Growth Officer.

Essential Duties and Responsibilities (others may be added)

As SVP of payor relations and reimbursement you (and your team) will:

• Establish a strategy for deepening relationship across our payor system inclusive of conference strategy, marketing, market access team, HEOR data etc.

• Drive private and government policy strategies to increase coverage of exome and genome testing

• Build short and long-term strategies for optimizing our billing and reimbursement workflows and experience

• Build/maintain strategic working relationships with key commercial, federal and state payors, external collaborators, advocates and pharma partners

• Work closely with the internal cross-functional team (e.g. medical affairs, marketing, sales, legal etc.) and key external advisors to gain/share relevant insights and monitor/apply

• trends that will impact market access and pricing strategies as well as scientific data generation. Communicate externally where applicable

• Manage and expand a rolodex of executive contracts across national and local payors

• Work with relevant internal partners to determine impact of reimbursement landscape to quarterly forecasting

• Proactively identify risks related to reimbursement and develop/communicate/implement action planning

• Engaged strategize cross functionally with members of the commercial leadership team to maximize impact commercially

• Travel required as needed for meetings/events.
  

Required Skills

• Bachelors degree with 15+ years related experience.

• Extensive experience driving reimbursement policy within the biotech or pharma space

• Experience working at the C Suite of major Payors across the US

• History of driving policy, coverage and adoption within the Medicaid space

• Ability to work independently having good presentation, leadership and team-building skills.

• Strong strategic acumen with sales and business mindset

• Extensive working knowledge of Medicare/Medicaid and health plan reimbursement methods

• Use of independent judgment and creativity applied to resolution of contract issues.

• Operates with a sense of urgency

• Ability to maintain composure while work on various assignments simultaneously in order to meet deadlines

• Strong analytical and interpersonal skills within all levels of the organization

• Willingness to travel, if and as required

• Ability to navigate within automated systems and proficiency in Outlook, Word and Excel

• Ability to travel up to 40%

Leadership behaviors:

• Actively models, exhibits and encourages self and all teammates to live the GeneDx Cultural Principles:

• Be adaptable to change

• Communicate directly, with empathy

• Do what we say we’re going to do

• Be bold in our vision & brave in our execution

• Operate with a bias for action

• Hardworking and rolls up sleeves in service of the work and team

• Team versus individual first. Always team first

• Challenge perceived limitations. Encourages and exhibits expansive thinking – takes a “how might we” approach to opportunities and challenges

• Innate intellectual curiosity and ability to diagnose the root cause of issues and understand if it is within our control to effect change. If it is, define action plans to address. If not, raise in the appropriate setting to the appropriate teammate(s)

• Exercises sound judgement and ability to execute in an environment of high velocity decision-making

• Strong executive presence. Has command of the subject/content, establishes credibility, is a concise and authoritative communicator and can connect with internal teammates and leaders as well as customers