Responsibilities

· Lead legal strategy and provide senior-level counsel on payer contracting, reimbursement, coverage, and broader market access matters, balancing legal risk with commercial and patient-access objectives.
· Independently lead the review, drafting, and negotiation of complex and strategically significant agreements with private payors, including commercial insurers and managed care organizations.
· Serve as a strategic legal advisor to Market Access and senior business leaders, providing proactive counsel on payer strategy, reimbursement frameworks, coverage initiatives, and emerging market access opportunities and risks.
· Shape the company's legal approach to reimbursement and payer strategy, translating complex legal and regulatory requirements into practical business recommendations.
· Lead legal support for reimbursement and appeals strategies, partnering with Market Access, Reimbursement, Commercial, and other stakeholders to develop approaches to complex payer and coverage challenges.
· Advise on compliance with applicable federal and state healthcare laws, regulations, and guidance affecting billing, coding, reimbursement, payer contracting, and coverage.
· Evaluate complex payer policies, coverage determinations, reimbursement requirements, and contractual provisions, identifying material legal, regulatory, and business risks and recommending appropriate strategies.
· Influence cross-functional decision-making by providing clear, pragmatic legal guidance that enables business objectives while appropriately managing organizational risk.
· Develop and implement legal frameworks, playbooks, contracting positions, templates, and scalable processes that improve consistency, efficiency, and risk management across payer contracting and reimbursement activities.
· Establish and deliver guidance and training for business leaders and internal stakeholders on payer contracting, reimbursement requirements, healthcare regulatory developments, and evolving market access considerations.
· Monitor and anticipate changes in the healthcare legal and regulatory landscape affecting managed care, reimbursement, coverage, and diagnostics, including federal policies such as PAMA and defrayal obligations, and evolving state biomarker coverage legislation, and proactively assess their potential impact on company strategy and operations. Partner with Legal and Compliance leadership on complex or high-risk matters, providing recommendations and escalating issues appropriately while maintaining ownership through resolution.
· Provide leadership and subject-matter expertise across the organization, helping strengthen organizational capabilities in healthcare, reimbursement, payer contracting, and market access.

Healthcare Market Access Counsel at Veracyte · LumiJobs

Healthcare Market Access Counsel

Responsibilities

Qualification

Required

Preferred

Benefits

Company

Veracyte

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