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Medical Science Liaison, Reimbursement (Open to Remote, Hybrid or On-Site)

Company: Guardant Health
Location: Boston
Posted on: June 25, 2022

Job Description:

Company DescriptionGuardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics. The Guardant Health Oncology Platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. Guardant Health has launched liquid biopsy-based Guardant360 -, Guardant360 CDx and GuardantOMNI - tests for advanced stage cancer patients. These tests fuel development of its LUNAR program, which aims to address the needs of early stage cancer patients with neoadjuvant and adjuvant treatment selection, cancer survivors with surveillance, asymptomatic individuals eligible for cancer screening and individuals at a higher risk for developing cancer with early detection.Job DescriptionThe Reimbursement Team at Guardant Health is an essential part of our company's success and is valued as such. We're committed to building for the future, focusing on optimizing billing and reimbursement and ensuring we stay true to our company mission and values in the process.As a Medical Science Liaison, Reimbursement, you play an important role in the overall success of the company. Working with the reimbursement team you will coordinate external appeals and peer-to-peer reviews with insurance companies to convey the value proposition of our technology and act as a clinical liaison with insurance companies to win reimbursement with advanced appeals. You will facilitate optimized billing processes and operations that are aligned with Guardant Health's mission and values.About The RoleYou're responsible for understanding the clinical literature of our product and understanding the disease landscape of our products and the product-market fit in relation to insurance companies' coverage policies. Leveraging our clinical literature and liaising with the clinical affairs team you will facilitate appeal template construction for several disease states including Lung, Colorectal, Breast, Prostate, and GI primary cancers. You will work with the entire appeals team to construct a personalized argument to refute the insurance company's denials to external review organizations, including IRBs, IROs, state departments of insurance as well as the office of personnel management. Additionally, you will analyze and coordinate a structured complaint process with URAC when the external appeal reviewers misinterpret data and incorrectly deny claims.Key groups to cross-functionally work with are Managed Care, Clinical Research, and Medical Affairs.Qualifications

  • You are interested in being on the ground floor of a dynamic, fast-paced organization.
  • You are organized and have strong attention to detail, are a self-starter, and can work with minimal supervision.
  • Tech-savvy and analytical, you enjoy unpacking and resolving complex issues.
  • Customer service is in your DNA, and you are known for your ability to communicate effectively through even the most tangled scenarios.
  • Your background includes a minimum of five years of work experience in a healthcare environment focused on healthcare reimbursement, including knowledge of health plan regulations and processes.
  • You have a clinical degree and have the ability to interpret clinical literature and medical records to construct an argument to justify medical coverage for claims.
  • Your previous experience in similar roles enables you to hit the ground running and contribute insights and solutions to your team.
  • You should have moderate Excel skills, like the ability to sort, filter, and perform simple calculations. You have experience working with a broad range of payers and have appealed to state-level agencies or external-level reviews with IRO/IRBs.
  • Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals, and national as well as regional payers throughout the country is a plus.Additional InformationCovid Vaccination Policy: Starting January 7, 2022, Guardant Health will require all employees to be fully vaccinated to either (a) establish that they have been fully vaccinated against COVID-19; or (b) request and obtain an approved exemption from Guardant's COVID-19 U.S. Vaccination Policy as a reasonable accommodation, as consistent with applicable laws. An employee is considered fully vaccinated against COVID-19 two weeks after receiving the second dose of a two-dose vaccine or one dose of a single-dose vaccination. Acceptable vaccines are approved or under emergency use authorization by the U.S. Food and Drug Administration (FDA) and/or the World Health Organization (WHO). In addition, fully-vaccinated employees will be required to maintain their fully-vaccinated status under this policy by obtaining, if applicable, any FDA-approved boosters.Employee may be required to lift routine office supplies and use office equipment. Majority of the work is performed in a desk/office environment; however, there may be exposure to high noise levels, fumes, and biohazard material in the laboratory environment. Ability to sit for extended periods of time.Guardant Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.All your information will be kept confidential according to EEO guidelines.To learn more about the information collected when you apply for a position at Guardant Health, Inc. and how it is used, please review our Privacy Notice for Job Applicants.Please visit our career page at: http://www.guardanthealth.com/jobs/, , ,

Keywords: Guardant Health, Boston , Medical Science Liaison, Reimbursement (Open to Remote, Hybrid or On-Site), Healthcare , Boston, Massachusetts

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