SkylineDx is a leading-edge biotechnology company specializing in the development of diagnostic tests for critical conditions such as multiple myeloma and melanoma. Our revolutionary products, Sky92 and Merlin, are transforming the way these diseases are understood, managed, and treated.

The Director of Managed Care and Reimbursement (DMCR) is responsible for planning and directing all aspects of the managed care functions within the company. This includes maintaining existing managed care relationships, crafting, and executing product-specific payer integration strategies that include Medicare, GSA, DoD and all variations of United States commercial plans. The DMCR is also responsible for all contract negotiations, execution and payer contract reimbursement compliance, team building as needed, and company managed care marketing initiatives.

RESPONSIBILITIES:

• Meet with health plan decision-makers, key opinion leaders such as physicians and healthcare professionals, and visit key payer and academic institutions.
• Interact with key commercial and government payer contacts.
• Manage collaboration projects such as health economics papers, cost effectiveness models, and coding analysis
• Respond to requests for information - clinical, financial, and technical - to internal colleagues and external payer clients.
• Identify and prioritizes target Managed Care Organizations by researching and evaluating service opportunities, market size, competitive environment, contract profitability and other applicable factors in order to increase market share, maximize profitable revenues, and meet or exceed overall business goal objectives.
• Maintain regular and open lines of communication with key and targeted customers by developing and managing close business relationships in order to monitor market conditions.
• Serve as chief liaison between SkylineDx and third-party payers
• Work closely with executive staff in developing comprehensive business plans as well as quarterly and annual revenue forecasts designed to meet and exceed the revenue and earnings objectives of the company.
• Effectively manage a portfolio of managed care contracts and associated revenue to meet / exceed company business objectives.
• Attend all company directed conferences, congresses, and industry trade shows, report information back to organization in a condensed and actionable manner.
• Maintain expertise in all matters related to the designated therapeutic area; latest clinical research, current therapies, current diagnostic tools available to treat disease, etc.
• Collaborate with other SkylineDx departments on contract reviews, payer compliance and recoupment efforts. Work cross functionally to develop and implement value-based/outcome based contracting strategy with payers

QUALIFICATIONS:

• Bachelor’s Degree or equivalent. Master’s Degree preferred
• Advanced knowledge of managed care for molecular diagnostics
• More than 10 years of experience driving positive commercial medical policy for molecular diagnostics
• Knowledge about molecular diagnostics, genomics, assay validation, statistics.
• Ability to comprehend and interpret clinical data.
• Ability to interpret an extensive variety of technical clinical information
• Excellent communication skills with proven ability to deliver impactful payer presentations.
• Strong interpersonal skills with ability to handle interactions with health plan medical directors and key opinion leaders.
• Team player able to motivate the team and manage both internal and external collaborations.
• Strong analytical skills and creative approach to problem solving.
• Used to work according to high-quality standards.
• Intrinsic motivation to make a positive contribution to health care. Excellent English oral and written skills are required.

At SkylineDx

We live to make a difference. It is our mission to improve a patient’s quality of life by enabling them to benefit from personal insights at the genomic level of their disease. That means we are continuously innovating the world of gene signature-based diagnostic testing. That also means we have a unique blend of characteristics. We have our soft side. Our culture is oftentimes described as familial, warm, loyal and highly engaged. We have our rational side where exact sciences are driving our mission. And when needed our passionate side surfaces to clear the way so we can serve society with science based solutions.

Our quotes

#serviceisjoy

#valueformoney

#playtogethertowin

#amazingthingshappen

#cogitoergosum

#itsyourparty

Do apply!

Send your resume to Nezam Etemadi (HR Manager) at the link provided. If you have questions or want more information, don’t hesitate to contact us. You’ll find the contact details on our website. We will make sure it lands on the right desk!

Job Type: Full-time

Pay: $220,000.00 - $260,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Application Question(s):

• Role involves a heavy amount of manual bench work. Are you open to manual bench work?

Ability to Commute:

• San Diego, CA 92109 (Required)

Work Location: In person