Director, Reimbursement Operations
Company: Guardant Health
Location: Redwood City
Posted on: February 22, 2021
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Job Description:
Company DescriptionGuardant Health is a leading precision
oncology company focused on helping conquer cancer globally through
use of its proprietary blood tests, vast data sets and advanced
analytics. The Guardant Health Oncology Platform leverages
capabilities to drive commercial adoption, improve patient clinical
outcomes and lower healthcare costs across all stages of the cancer
care continuum. Guardant Health has launched liquid biopsy-based
Guardant360--, Guardant360 CDx and GuardantOMNI-- tests for
advanced stage cancer patients. These tests fuel development of its
LUNAR program, which aims to address the needs of early-stage
cancer patients with neoadjuvant and adjuvant treatment selection,
cancer survivors with surveillance, asymptomatic individuals
eligible for cancer screening and individuals at a higher risk for
developing cancer with early detection.Job
Description====================================This role works out
of our Redwood City, CA office.Due to the Covid 19 Pandemic
Guardant Health has temporarily classified this role as 'working
from home status,' scheduled to return onsite in Redwood city, CA
when it is determined safe to do
so.====================================Position SummaryThe Director
of Reimbursement has in-depth expertise in developing and
implementing strategic and tactical reimbursement/market access
initiatives in the US. A key focus of this position is to
collaborate with Guardant Health insurance companies, physicians,
hospitals and government agencies. The role is also focused on
supporting internal and external customers as well as key
stakeholders in all aspects of the reimbursement process. The
internal support will rely heavily on program management software
infrastructure projects to automate processes to maximize
efficiency and claim reimbursement. These skills would include
eligibility automation, prior authorization automation, LIMS
integration with the cloud sourced billing tool and Salesforce. The
candidate should have significant knowledge in laboratory billing
laws regulations and compliance activities to ensure that when
interfacing with new product development they are able to provide
guidance around the parameters required to successfully
commercialize new tests. The candidate is highly skilled at
developing relationships as well as working across the organization
to achieve reimbursement and patient access goals that are aligned
with sales and marketing strategies.Essential Duties And
Responsibilities* Acts as company subject matter expert in billing
and payment strategy focusing on optimizing revenue cycle
management to achieve maximum reimbursement.* Manages a team to
ensure approval and correct processing of patient claims to
insurance companies with high customer satisfaction.* Oversees the
design and build a Patient Financial Assistance Program.* Partners
with our internal resources to develop internal metrics and
optimization strategies for data and history, enabling development
of simple and easily accessible data that will be used to direct
our reimbursement strategy for new and exsiting products.* Oversees
the strategy and development of internal operational policies and
SOPs that will scale with the organization.* Builds and sustains
positive partnerships with Payers and Providers, to ensure
processes are in place to ensure contracts are loaded and claims
adjudication is managed in a manner consistent with contractual or
regulatory language.* Collaborates with internal and external
stakeholders to successfully resolve challenges with patient
billing and other provider issues.* Manages and supports the
operational and administrative process for billing, ensuring
efficient, effective and compliant revenue cycle management.*
Interfaces regularly with finance to be able to help with FP&A
as well as SOX and determination of ASP for productsQualifications*
5+ years professional experience in Reimbursement and Billing in a
life sciences, payer setting* 5+ years management experience with a
billing team* Bachelor's degree required; graduate degree in a
related field such as public health or public policy preferred*
Experienced working with payers as a laboratory that bills
molecular tests.* Experience and knowledge of federal and state
legislative environments and regulatory processes to dissect
complex scenarios and are able to bring issues to swift
resolution.* Expert in medical billing, third party payers and
patient interface, patient privacy and confidentiality paramount.*
Follow payer policy activities on coverage and payment technology
processes and practices* In-depth knowledge of SOP development in a
HIPAA-compliant environment and molecular billing codes and
regulations.* A highly effective people manager and have experience
in vendor management, with a keen focus on optimizing processes and
practices in a rapidly changing environment.* Program management
and systems engineering skills are a significant plus to assist
with process design.* Strong analysis skills and ability to
interface a variety of software tools to quickly perform analyses
to answer questions and make decisions. Excel skills are mandatory,
SQL or other databasing skills are desireableAdditional
InformationEmployee may be required to lift routine office supplies
and use office equipment. Majority of the work is performed in a
desk/office environment; however, there may be exposure to high
noise levels, fumes, and biohazard material in the laboratory
environment. Ability to sit for extended periods of time.Guardant
Health is an Equal Opportunity Employer. All qualified applicants
will receive consideration for employment without regard to race,
color, religion, sex, sexual orientation, gender identity, national
origin, or protected veteran status and will not be discriminated
against on the basis of disability.All your information will be
kept confidential according to EEO guidelines.To learn more about
the information collected when you apply for a position at Guardant
Health, Inc. and how it is used, please review our Privacy Notice
for Job Applicants.Please visit our career page at:
http://www.guardanthealth.com/jobs/
Keywords: Guardant Health, Redwood City , Director, Reimbursement Operations, Executive , Redwood City, California
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