Director of Managed Care
Location: US, NY, New York
Employment type: Full-time
Required experience: Associate
Required education: Bachelor's Degree
Industry: Biotechnology
Company profile: Recombine provides clinical genetic testing. CarrierMap, the first product created at Recombine, is the most comprehensive, cost-effective clinical genetic test, currently being provided to thousands of patients around the world through our network of physicians. Our company was founded by experts in fertility, clinical genetics, bioinformatics and computer science brought together with one goal in mind: to improve health outcomes based on actionable and responsible genetic testing.
Description: Recombine is advancing personalized medicine by translating developments from the fields of genomics and computer science into cost-effective, cutting-edge genetic diagnostics. We develop new products in a way that is ethically upstanding, medically meaningful, clinically actionable, and practically useful for patients and providers.  Our first product, CarrierMap, helps identify couples at risk of passing a genetic disease to their children, and is currently being provided to thousands of patients around the world through our network of physicians. Our company was founded by experts in fertility, clinical genetics, bioinformatics and computer science brought together with one goal in mind: to improve health outcomes based on actionable and responsible genetic testing. What You Will Be DoingResponsible for building & executing a strategy for contracting with 3rd party payers and MCOs throughout the United States.Research & learn about various Insurance & MCO needs for varying regions.Develop existing billing strategy and protocols, including ICD and CPT codes and associated fees.Devise solutions to ensure access to optimal reimbursement for genetic testing.Participate in high-level product commercialization planning with respect to how it fits into MCO strategy.Work with legal counsel to develop contracting strategy across various verticals.Participate and contribute to an environment where collaboration & cross-over of domain expertise (genomics, computer science, medicine, data-science, finance, clinical genetics) helps to drive an industry forward to improve healthcare.
Requirements: About You5-7 years experience building relationships, securing high-level presentations, and establishing and executing contracts with large private insurance companies and MCOs throughout the United States.Well established relationships with key payers.Intimate knowledge of not just how payers think, but the decision-makers at every level along the way.Deep familiarity with Molecular Diagnostics, Laboratory Developed Tests (LDTs) & Prenatal/Preconception Genetic Testing and the associated medical billing landscape.Hard-working. Not just a delegator; a hands-on doer.Excited about the opportunity to shape personalized genomic medicine.
Benefits: Participate and contribute to an environment where collaboration & cross-over of domain expertise (genomics, computer science, medicine, data-science, finance, clinical genetics) helps to drive an industry forward to improve healthcare.Comprehensive benefits package including health insurance and matching 401(k).Group outings, lunches, happy hours and co-workers who inspire you every day.
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