Associate Director, Reimbursement Operations (REMOTE)
Company: Guardant Health
Location: Kansas City
Posted on: May 14, 2022
Guardant Health is a leading precision oncology company focused on
helping conquer cancer globally through use of its proprietary
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 commercially launched Guardant360 -, Guardant360 CDx,
Guardant360 TissueNext---, Guardant360 Response---, and
GuardantOMNI - tests for advanced stage cancer patients, and
Guardant Reveal--- for early-stage cancer patients. These tests
fuel development of its screening program, which aims to address
the needs of asymptomatic individuals eligible for cancer
(This position is open to REMOTE candidates, however, preference
will be given to those who are based in the San Francisco Bay
Reimbursement Operations is a critical function that fuels our
mission to conquer cancer with data. The Associate Director of
Reimbursement Operations plays a key leadership role in managing
our operations with insurance payors, patients, clients, and
internal stakeholders. The ideal candidate is one who is a highly
effective leader who can drive improvements and manage multiple
The Associate Director of Reimbursement Operations has in-depth
expertise in developing and implementing strategic and tactical
reimbursement/market access initiatives in the US. A key focus of
this position is to collaborate with Guardant Health insurance
companies, physicians, hospitals and government agencies. The role
is also focused on supporting internal and external customers as
well as key stakeholders in all aspects of the reimbursement
process. The internal support will rely heavily on program
management software infrastructure projects to automate processes
to maximize efficiency and claim reimbursement. The candidate
should have significant knowledge in laboratory billing laws
regulations and compliance activities to ensure that when
interfacing with new product development they are able to provide
guidance around the parameters required to successfully
commercialize new tests. The candidate is highly skilled at
developing relationships as well as working across the organization
to achieve reimbursement and patient access goals that are aligned
with sales and marketing strategies.
Essential Duties and Responsibilities:
Acts as company subject matter expert in billing and payment
strategy focusing on optimizing revenue cycle management to achieve
Manages a team to ensure approval and correct processing of patient
claims to insurance companies with high customer satisfaction.
Partners with our internal resources to develop internal metrics
and optimization strategies for data and history, enabling
development of simple and easily accessible data that will be used
to direct our reimbursement strategy for new and exsiting
Oversees the strategy and development of internal operational
policies and SOPs that will scale with the organization.
Builds and sustains positive partnerships with Payers and
Providers, to ensure processes are in place to ensure contracts are
loaded and claims adjudication is managed in a manner consistent
with contractual or regulatory language.
Collaborates with internal and external stakeholders to
successfully resolve challenges with patient billing and other
Manages and supports the operational and administrative process for
billing, ensuring efficient, effective and compliant revenue cycle
Interfaces regularly with finance to be able to help with FP&A
as well as SOX and determination of average service price for
5+ years professional experience with reimbursement and billing in
laboratory diagnostics, revenue cycle consulting, or
5+ years management experience with leading teams of 10+ people or
more. We are looking for highly-effective leaders that can drive
Demonstrated track record for streamlining revenue cycle functions,
particularly back-end functions such as payment posting, denials
management, appeals management, and follow-up.
High proficiency with analytics tools and able to use them to help
identify opportunities and make decisions. Strong Excel skills are
a must. Salesforce, Tableau, and SQL a plus.
Strong knowledge of billing systems (specifically XIFIN) a major
Bachelor's degree required; graduate degree in a related field such
as public health or public policy preferred
Experience working with payers as a laboratory that bills molecular
Knowledge of federal and state legislative environments and
regulatory processes to dissect complex scenarios and are able to
bring issues to swift resolution.
In-depth knowledge of SOP development in a HIPAA-compliant
environment and molecular billing codes and regulations.
Program management and systems engineering skills are a significant
plus to assist with process design.
Covid 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
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 .
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Keywords: Guardant Health, Kansas City , Associate Director, Reimbursement Operations (REMOTE), Executive , Kansas City, Kansas
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