Director of Market Access, Policy Development

Do you want to join a mission-driven company and help develop prenatal and oncology diagnostics that can affect the lives of millions of patients? 

BillionToOne (Y Combinator S17), ranked at the top 5% of Y Combinator companies with $100M+ in funding from prominent VC firms, has developed a DNA molecular counter that increases the cell-free DNA diagnostics resolution by over 1,000 fold. BillionToOne's first product, UNITY™ is the first and only prenatal screen that directly assesses the baby's risk for common and severe inherited disorders such as cystic fibrosis, spinal muscular atrophy (SMA), and hemoglobinopathies from a single tube of blood from the pregnant mother.

BillionToOne is looking for a Director or Sr. Director of Market Access, Policy Development to develop and implement coverage and coding strategies that will gain access and acceptable reimbursement with all payors (State Medicaid, Medicare, GSA, Tricare, and commercial payors). Reporting to the Vice President of Market Access, the Director of Market Access works with medical affairs, sales, marketing, laboratory operations, and other applicable company personnel to secure coverage and reimbursement for BillionToOne tests to maximize company sales.

This position is remote and requires 40% travel. 

Key Responsibilities:

• This individual will possess a strong understanding of reimbursement and health care policy, CMS, and MolDX process.
• Support developing medical policy for Unity Screen™, Northstar Select™, and Northstar Response™.
• The individual will lead initiatives and execution of coding, coverage, and payment strategies.
• Support a proactive, comprehensive CMS/MolDX strategy.
• Maximize relationships with Medicaid programs to ensure appropriate coverage and reimbursement for company services and act as lead for all internal State Medicaid efforts.
• Coordinate with RCM to ensure BillionToOne recognizes revenue consistent with reimbursement and coverage policies, identifies opportunities, and develops strategies to improve reimbursement experience.
• Monitor CMS and HHS agency activities of interest to BillionToOne that shape the formulation of relevant public policy issues.
• Interpret existing and emerging payer policies, competitive landscape, trends, pricing, contracting strategies, and potential barriers to provider and patient access.
• Work across a matrix with colleagues in commercial, medical affairs, communications, patient advocacy, and other parts of Corporate Affairs to achieve business goals.

 Requirements:

• Bachelor’s degree in science, business, or health care related field required.
• 3 to 5 years experience in Payor account management, including experience in developing local coverage determinations and medical policy for new technology.
• 3-5 years of Payor Access experience within the diagnostic sector.
• Experience in managing key customer or Market Access relationships, creating and presenting technical presentations to senior-level managers and medical directors
• Demonstrated ability to Identify and cultivate relationships with key contacts within health plans, including Medical Directors, medical policy, medical management, and pricing/reimbursement personnel.
• Experience in AMA CPT coding process for new CPT codes.

Knowledge, Skills & Abilities:

• Experience developing and executing strategic plans to obtain optimal payer coverage/policies and reimbursement for prenatal/oncology tests.
• Self-driven, passionate, innovative, and able to manage multiple tasks in a fast-paced environment.
• Ability to build cross-functional teams that share information and achieve positive results.
• Ability to manage multiple projects that are highly complex in nature and broad in scope.
• Competent in computer skills. Familiar with Microsoft Office programs such as Access, Word, Excel, and PowerPoint
• High level of intensity, enthusiasm, and professionalism

Benefits And Perks:

• Working with a team of ‘rockstars’ who bring out the best in everyone
• Open, transparent culture that includes weekly Town Hall meetings
• The ability to indirectly or directly change the lives of hundreds of thousand patients
• Multiple medical benefit options; employee premiums paid 100% of select plans, dependents covered at 80%
• Extremely generous Family Bonding Leave for new parents (16 weeks, paid at 100%)
• Retirement savings program including a 4% Company match
• Free daily on-site lunches provided from top eateries
• Latest and greatest hardware (laptop, lab equipment, facilities)
• A variety of perks on campus (state of the art gym, restaurant)
• Free on-site EV charging (compatible with all EVs, including Tesla)

At BillionToOne, we are proud to offer a combination of a (1) base pay range (actual amount offered is based experience and salary/equity options split that the candidate chooses) (2) generous equity options offering, on top of (3) industry leading company benefits (free healthcare options, 401k match, very generous fully paid paternal leave etc.).

For this position, the base pay range is: $175,000-$225,000 per year

BillionToOne is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.