Sr. Manager Market Access Strategy

Abbott is a global healthcare leader advancing diagnostics, medical devices, nutritionals, and medicines to help people live more fully. The Senior Manager, Regulatory & Market Access Strategy serves as a strategic advisor on regulatory, reimbursement, and health policy matters affecting cancer screening and diagnostic products, guiding policy strategy, reimbursement implementation, and patient access.

Responsibilities:

• Serve as a strategic advisor on coding, coverage, and payment strategy for pipeline and on-market products, assessing competitive positioning, reimbursement risks and opportunities, and translating requirements into actionable guidance for commercial, field, laboratory, and operational teams
• Lead and support operational implementation of reimbursement requirements, including Advanced Diagnostic Laboratory Test (ADLT) collection and reporting, new coverage mandates, and state biomarker, cancer screening, and other applicable coverage laws; partner across Market Access, Revenue Cycle, Laboratory Operations, and other functions to resolve systemic reimbursement, billing, and payer-performance issues and optimize appeal strategies
• Serve as a subject-matter expert on federal and state health policy and reimbursement issues affecting laboratory diagnostics, including Medicare Part B payment, PAMA, laboratory regulation, prior authorization, coverage mandates, CMS policy and rulemaking, and the broader coding, billing, coverage, and reimbursement environment
• Monitor legislative, regulatory, and payer-policy developments; translate changes into business implications, risks, opportunities, and recommended actions; and lead or coordinate cross-functional responses, executive communications, company positions, regulatory comments, and other agency submissions
• Represent ACD in trade associations, coalitions, and advocacy organizations to help develop and advance policy positions that support patient access and the ACD portfolio, while maintaining current expertise in emerging reimbursement requirements, industry trends, and market-access practices

Requirements:

• Bachelor's degree in a relevant field aligned with the essential duties
• 8+ years of experience advising healthcare organizations on legal, regulatory, and strategic matters related to government and commercial insurance coverage, billing and reimbursement, fraud, waste and abuse, provider licensing, and patient or consumer protection
• 5+ years of experience advising CLIA laboratories on legal and/or Market Access strategy matters related to diagnostics
• Advanced knowledge of official healthcare billing and coding guidelines, including requirements from CMS and other agencies within the U.S. Department of Health and Human Services (HHS)
• Basic knowledge of the Medicare Molecular Diagnostics (MolDx) program
• Demonstrated experience engaging with trade associations, coalitions, and state advocacy groups and translating legislative and regulatory language into business and operational impact
• Experience translating legislative and regulatory language into business and operational impact
• Excellent written and verbal communication skills, with the ability to distill complex policy and reimbursement issues into clear, actionable recommendations for stakeholders and senior leadership
• Strong organizational skills with the ability to manage multiple priorities and large cross-functional initiatives in a fast-paced, matrixed environment
• advanced degree
• J.D. degree
• Advanced understanding of healthcare provider revenue cycle functions, processes, and healthcare IT systems
• Advanced knowledge of and experience engaging directly with MolDx, including submissions of Technical Assessments