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Market Access Analyst

Organization

GeneDx/Sema4

Job Location

REMOTE POSITION
Gaithersburg, MD 20877
United States

Job Description

As a Market Access Analyst you will have primary responsibility for conducting business analysis that informs the payer relations and channel innovations strategy.  Market Access Analyst will support the development of business analytics that drive commercial strategy and forecasting related to Sema4 covered and reimbursed products and services. Market Access Analyst will support the development and implementation of payer contract management tools. Market Access Analyst will act as the liaison between payer relations and revenue cycle management and establish routine reporting highlighting areas of improvement as well as opportunity.  The Market Access Analyst  will report to the Manager of Market Access.

RESPONSIBILITIES 

Serve as key member of Market Access team with continuous input into team goals, objectives, and strategies.
Lead implementation of payer contract pricing and performance models to support revenue and coverage maximization.  
Develops and maintains analytical reports including key performance metrics, contract performance updates, and ad-hoc reporting solutions specific to market access, channel innovations, and provider relations.  
Supports Payer Relations Team by coordinating contract amendment strategies.  
Provides contract disputes and appeal mitigation strategies to support Payer Relations and Revenue Cycle Management Teams. 
Supports development of benefit and risk analysis for contracting scenarios including proposing alternative solutions. 
Leads the development and ongoing contract reporting needs related to Market Access documents on a regular and/or ad-hoc basis as requested. 
Provides support to cross-functional stakeholders related to revenue cycle management activities, including but not limited to Business Development. 
Creates and maintains Sema4 product and service payer and provider fee schedule including billing code mapping. 
Participates in external and internal audits, as required. 
Coordinates meeting agendas, document minutes, outline actions and provide status updates for market access and managed care projects.   
Develops subject matter expertise on relevant regulatory, legislative and policy topics. 
Identify business needs proactively and build analysis in order to mitigate risk and improve results..
Performs other duties as needed. 

Requirements

QUALIFICATIONS 

Education: 

Bachelor’s degree required   
5-7+ years of healthcare related experience 
At least 2+ year payer related experience preferred  

Skills: 

Collaborative spirit with both internal and external stakeholders 
Demonstrated ability to solve complex problems 
Desire to work independently in a dynamic and rapidly evolving environment. 
Excellent written, verbal, and interpersonal skills for executive level communication and collaboration required 
Demonstrated quantitative and analytical capabilities,  
Demonstrated ability to synthesize complex information into simplified, user-friendly, persuasive formats and presentations 
Advanced Microsoft Office Excel® and PowerPoint® skills required