Director, Market Access – CMS Coverage & Reimbursement Policy
Illumina · Remote (Remote US)
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About the role
What if the work you did every day could impact the lives of people you know? Or all of humanity?
At Illumina, we are expanding access to genomic technology to realize health equity for billions of people around the world. Our efforts enable life-changing discoveries that are transforming human health through the early detection and diagnosis of diseases and new treatment options for patients.
Working at Illumina means being part of something bigger than yourself. Every person, in every role, has the opportunity to make a difference. Surrounded by extraordinary people, inspiring leaders, and world changing projects, you will do more and become more than you ever thought possible.
The Director, Market Access – CMS Coverage & Reimbursement Policy will lead the company's strategy for Medicare coverage, coding, reimbursement, and federal payment policy affecting genomic sequencing and genetic testing. This individual will serve as the company's primary expert on CMS coverage policy, Medicare Administrative Contractors (MACs), coding processes, reimbursement methodologies, and federal regulatory developments impacting access to genomic sequencing and genetic testing.
Working closely with Government Affairs, Medical Affairs, HEOR, Clinical Affairs, Regulatory Affairs, and Commercial teams, this leader will develop evidence-based strategies that improve Medicare beneficiary access while shaping national reimbursement policy.
Responsibilities
Lead Medicare market access strategies for genomic sequencing and genetic testing.
Develop strategies for NCDs, LCDs, MolDx, MAC engagement, CLFS pricing, CPT/PLA coding, and reimbursement.
Monitor CMS rulemaking and federal reimbursement policy developments.
Partner with Government Affairs on federal advocacy and policy initiatives.
Collaborate with Medical Affairs and HEOR to develop evidence supporting Medicare coverage.
Represent the company with CMS, Medicare contractors, and industry organizations.
Requirements
Bachelor's degree required; advanced degree preferred (MPH, MHA, PharmD, PhD, JD, MBA, or equivalent).
10+ years of experience in Medicare reimbursement, federal health policy, or market access.
Demonstrated experience leading Medicare coverage and reimbursement strategies for genomic sequencing, genetic testing, molecular diagnostics, precision medicine, or other advanced diagnostic technologies.
Over 5 years of direct experience working with CMS, Medicare Administrative Contractors (MACs), MolDx, or other Medicare reimbursement and policy organizations. Ideal candidates would have worked at CMS.
Demonstrated success influencing Medicare coverage, coding, pricing, or reimbursement policy.
Deep knowledge of NCDs, LCDs, CLFS, CPT and PLA coding, gapfill and crosswalk pricing, and Medicare payment policy.
Excellent policy analysis, stakeholder engagement, and executive communication skills.
Travel
Approximately 25–35% travel.
The estimated base salary range for the Director, Market Access – CMS Coverage & Reimbursement Policy role based in the United States of America is: $187,400 - $281,000. Should the level or location of the role change during the hiring process, the applicable base pay range may be updated accordingly. The range reflects long‑term growth in the role; therefore, most candidates are hired between the minimum and middle of the range. Placement depends on experience, skills, location, and internal equity. Additionally, all employees are eligible for one of our variable cash programs (bonus or commission) and eligible roles may receive equity as part of the compensation package. We offer a wide range of benefits as innovative as our work, including access to genomics sequencing, family planning, health/dental/vision, retirement benefits, and paid time off.
Continued in Illumina’s original posting ↗.
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