Director, Market Access

KEY RESPONSIBILITIES

• Develop and execute strategic payer account plans that expand coverage, contracting, and reimbursement for Baylor Genetics testing, with priority emphasis on WGS-first policies.
• Establish trusted, value-based partnerships with national and regional commercial health plans, Medicare Advantage organizations, Medicaid and Managed Medicaid plans, integrated delivery networks, and other risk-bearing entities.
• Lead payer negotiations that translate clinical and economic value into favorable coverage policies, fee schedules, network agreements, value-based arrangements, and administrative pathways.
• Create payer-specific value propositions that connect WGS-first testing to improved diagnostic yield, earlier clinical decision-making, reduced serial testing, fewer avoidable procedures, and lower total cost of care.
• Partner with HEOR, Medical Affairs, Clinical Affairs, Product, Finance, Revenue Cycle, and Commercial teams to develop evidence strategies, budget-impact models, cost-offset analyses, real-world evidence, and payer-facing value dossiers.
• Lead collaborative payer initiatives, pilots, and evidence-development partnerships that quantify net health outcomes, utilization impact, patient journey improvements, and cost savings associated with WGS-first coverage.
• Secure positive medical policies and reduce restrictive prior authorization, documentation, coding, and reimbursement barriers.
• Monitor payer policy, reimbursement, competitive, and regulatory trends and convert insights into actionable account strategies and executive recommendations.
• Maintain accurate account plans, opportunity forecasts, contracting milestones, risks, decisions, and next steps within established business systems.
• Represent Baylor Genetics at payer medical-policy reviews, value-evidence meetings, industry forums, and cross-functional executive discussions.

Core Deliverables

• Value-based payer partnership strategy and prioritized account plans.
• WGS-first payer value narrative supported by clinical utility, HEOR, and real-world evidence.
• Coverage-policy submissions, contracting proposals, value dossiers, and budget-impact materials.
• Payer pilots and collaborative evidence-generation initiatives with defined measures, milestones, and decision criteria.
• Executive reporting on covered lives, contracted lives, reimbursement performance, pipeline progress, risks, and expected financial impact.

Key Success Metrics

• Growth in covered commercial, Medicare, Medicaid, and Managed Medicaid lives.
• Number and quality of positive WGS-first and portfolio coverage-policy decisions.
• Increase in contracted payer lives and favorable reimbursement arrangements.
• Payer partnerships, pilots, and HEOR collaborations launched and completed against defined milestones.
• Demonstrated evidence of improved net health outcomes, reduced diagnostic utilization, shorter time to diagnosis, or total-cost-of-care savings.
• Reduction in payer denials, prior-authorization friction, and administrative barriers.
• Achievement of annual market access, contracting, reimbursement, and revenue objectives.
• Accuracy of account forecasts and timely execution of strategic account plans.

QUALIFICATIONS

Required

• Bachelor’s degree in Life Sciences, Business, Healthcare Administration, Public Health, Health Economics, or a related field.
• 14+ years of progressive experience in market access, payer strategy, reimbursement, managed care contracting, HEOR, or molecular diagnostics.
• Demonstrated success securing payer coverage, negotiating contracts, improving reimbursement, or building value-based payer partnerships.
• Working knowledge of commercial, Medicare, Medicaid, and Managed Medicaid coverage and reimbursement pathways.
• Ability to interpret and communicate clinical utility, health-economic, real-world evidence, budget-impact, and total-cost-of-care analyses to payer audiences.
• Executive-level communication, negotiation, deductive storytelling, and cross-functional influence skills.
• Ability and willingness to travel approximately 40% domestically.

Preferred:

• MBA, MPH, MHA, MS, PharmD, PhD, or equivalent advanced degree.
• Experience in genomics, molecular diagnostics, rare disease, oncology, reproductive genetics, women’s health, WGS, or WES.
• Established relationships with national and regional health plans, payer medical directors, policy teams, and contracting leaders.
• Experience designing or executing HEOR studies, budget-impact models, real-world evidence programs, value dossiers, or payer pilots.
• Experience advancing WGS-first or comprehensive genomic testing coverage strategies.

COMPETENCIES

✓ Strategic Payer Leadership ✓ Value-Based Partnership Development

✓ HEOR & Evidence Translation ✓ Contracting & Negotiation

✓ Executive Presence & Influence ✓ Cross-Functional Collaboration

✓ Financial & Data Acumen ✓ Accountability & Execution Excellence

✓ Innovation & Change Leadership ✓ Patient Access Orientation

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• Location: Remote
• Physical demands for the job (e.g., Must be able to lift 25 lbs, standing for prolonged periods of time, etc.)
• Work environment required for the job duties (e.g., Exposure to laboratory chemicals, etc.)
• Travel Requirements
• Special conditions (e.g. lab/clinical requirements if applicable)
• Approx 40% domestic Travel

EEO STATEMENT

Baylor Genetics is proud to be an equal opportunity employer committed to fostering an inclusive and diverse workplace. We welcome and encourage applicants from all backgrounds to apply. We do not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, age, veteran status, disability, genetic information, pregnancy, childbirth, or any other status protected by applicable federal, state, or local law. If you need an accommodation during the application process, please contact our Human Resources team.