Senior Director Of Policy & Reimbursement #4047

Responsibilities:

• CMS Strategic Engagement:
• Develop and maintain a strategic plan for proactive engagement with CMS, the Office of the Administrator, the Center for Clinical Standards and Quality (including the Chief Medical Officer and the vitally important Center for Coverage and Analysis), and the Center for Medicare, ensuring alignment with corporate goals for product accessibility and patient stakeholder priorities.
• Lead engagement with CMS and implementation of coverage workstreams, including coverage policy for multi-cancer early detection.
• Collaborate closely with the SVP and company leadership to execute engagement strategies that promote comprehensive coverage and meaningful reimbursement.
• Navigate CMS regulatory frameworks and leverage CAG processes to advocate for the inclusion and support of our products in public insurance programs.

• Monitor external policy developments and industry trends to identify opportunities and mitigate risks.
• Lead the development and execution of policy strategies on federal and state legislative and regulatory issues.
• Produce and spearhead comment letters on behalf of GRAIL and actively participate in policy discussions to align on company policy positions.
• Support government affairs and strategic alliances through policy research projects and material development.
• Engage with industry trade associations to promote and align on company policy priorities.
• Develop and maintain processes to ensure organizational awareness of government policies affecting GRAIL and respond to such policies in collaboration with internal government affairs and business partners.

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  Additional Coverage and Reimbursement:
• Manage/direct external consultants on GRAIL public payer reimbursement activities.
• Collaborate with the VP of Market Access to ensure our cross-pollination of public and private payer strategies, including identifying opportunities for coverage.
• Coordinate with internal stakeholders across Commercial, HEOR, Medical Affairs, Regulatory Affairs, and Marketing to enhance support for product coverage and reimbursement strategies.
• Collaborate with HEOR colleagues on analytics development to demonstrate the value of early cancer detection for Medicare and other public payers.
• Work cross-functionally to support evidence-generation planning for coverage.
• Acts as a resource on reimbursement and related health policy issues to internal business areas, industry partners, and regulatory agencies.

Preferred requirements:

• Bachelor’s degree required; advanced degree preferred.
• Minimum of 12 years of experience in public policy at the national or state level, with a focus on healthcare product coverage and payment.
• Proven leadership in navigating complex policy issues and implementing strategic reimbursement plans.
• Extensive knowledge of public program coverage, including Medicare and Medicaid.
• Understanding of the molecular diagnostics and screening market is preferred.
• Strong capability to develop and maintain robust internal and external relationships, enhancing the company’s policy positions.
• Experience with health outcomes research studies is advantageous.
• Exceptional interpersonal, communication, and organizational skills.
• Innovative, energetic, and resourceful with a diplomatic and intuitive approach. Commitment to communal success and the idea that we succeed only by helping teammates succeed.