The Medical Policy Specialist is a critical position to the company, responsible for providing clinical support ensuring the sustainment and growth of Myriad business with key Blue Cross Blue Shield payers. This role reports directly to the Director of Payer Markets and will work cross-functionally to establish and execute payer-specific strategies and tactics. The role has responsibilities to review evidence, data and publications to create and complete clinical submissions. A position is currently available with responsibilities focusing on BCBS payers in the Eastern United States
Location: This is a home-office based position but residence in one of the states covered is preferred. Area covering: Eastern United States.
Educate payers regarding Myriad's portfolio of genetic products in the oncology, urology, neuroscience, women's health, dermatology, and autoimmune disease states.
Assist Myriad in messaging and positioning new testing services to payer organizations. This process may be accomplished via in-person meetings, email, webinar, and telephone conversations.
Specific responsibilities with literature searches, understanding and analyzing clinical studies and data to create, write, and edit medical policy submissions to payers and/or technical assessment groups.
Gather and analyze coverage data to develop and prioritize company objectives.
Work closely with current Medical Policy Specialist and other members of the Managed Care team to implement the goals and strategies of the company. .
Assist in the creation of educational and training materials used to communicate company services.
Employ strong project management skills by prioritizing and leading multiple tasks concurrently.
Gain a detailed operational knowledge of assigned account customers and be adept at helping those customers identify their specific needs.
Work closely with Myriad's sales, customer service, medical policy specialist, billing and medical services teams to identify contracting and process improvement opportunities consistent with company objectives.
Candidates for the position include Board Certified/Board Eligible genetic counselors, licensed Advanced Practice Nurses or Registered Nurse, PharmD or PhD with a minimum of 3 to 5 years relevant experience.
Candidates should have well developed organizational, communication, presentation and project management skills.
Candidates should have the ability to interact effectively in team environment regardless of personnel function or reporting responsibilities.
Strong knowledge of healthcare industry and validated success working with commercial insurers or government payers is preferred. Approximately 20-25% travel is required.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; talk; or hear. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; and stoop; kneel; or crouch The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision and depth perception.