Senior Director, Reimbursement – Oncology
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Job Description
Senior Director leading reimbursement, billing, and patient access strategy for Guardant Health’s precision oncology testing business. Automating revenue-cycle processes and managing payer, provider, and billing operations.
Responsibilities:
- Act as company subject matter expert in billing and payment strategy, focusing on optimizing revenue cycle management and maximizing reimbursement
- Manage a team responsible for approval and correct processing of patient claims with high customer satisfaction
- Oversee the design and build of a Patient Financial Assistance Program
- Develop internal metrics and optimization strategies for reimbursement data and history
- Partner with internal and external software developers to enable automated workflows and process efficiency for revenue cycle management
- Oversee strategy and development of scalable internal operational policies and SOPs
- Build and sustain partnerships with payers and providers
- Ensure contracts are loaded and claims adjudication is managed consistently with contractual and regulatory language
- Collaborate with internal and external stakeholders to resolve patient billing and provider issues
- Manage and support billing operations and administration for efficient, effective, and compliant revenue cycle management
- Interface with finance on FP&A, SOX, and determination of ASP for products
- Provide reimbursement guidance for commercialization of new tests
Requirements:
- 15+ years total experience
- 5+ years of professional experience in Reimbursement and Billing in a life sciences or payer setting
- 5+ years of management experience with a billing team
- Bachelor’s degree required
- Graduate degree in a related field such as public health or public policy preferred
- Open to travel up to 15%
- Experience working with payers as a laboratory that bills molecular tests
- Knowledge of federal and state legislative environments and regulatory processes
- Expertise in medical billing, third-party payers, patient interface, privacy, and confidentiality
- Knowledge of SOP development in a HIPAA-compliant environment and molecular billing codes and regulations
- Experience in people management and vendor management
- Strong analysis skills and ability to interface with a variety of software tools
- Excel skills mandatory
- SQL or other databasing skills desirable
- Program management and systems engineering skills a significant plus
- AI or PowerAutomate experience a significant plus
- Curiosity, sound judgment, and ability to critically evaluate and responsibly leverage AI-enabled tools in accordance with company policies, ethical standards, and regulatory requirements
- Background screening including criminal history required
Benefits:
- Hybrid work model with work-from-home days for eligible onsite employees
- Flexible work-life balance through scheduled in-office and focused work-from-home days
- Reasonable accommodations for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs
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