Director, Market Access – CMS Coverage & Reimbursement Policy

Illumina • Washington DC, WA

11d

About The Position

The Director, Market Access – CMS Coverage & Reimbursement Policy will lead Illumina’s strategy for Medicare coverage, coding, reimbursement, and federal payment policy affecting genomic sequencing and genetic testing. The director will serve as the company’s primary expert on CMS coverage policy, Medicare Administrative Contractors (MACs), coding processes, reimbursement methodologies, and federal regulatory developments that impact access to genomic sequencing and genetic testing. The role works closely with Government Affairs, Medical Affairs, HEOR, Clinical Affairs, Regulatory Affairs, and Commercial teams to develop evidence-based strategies that improve Medicare beneficiary access and shape national reimbursement policy. The position involves approximately 25–35% travel and is not eligible for visa sponsorship.

Requirements

• Bachelor’s degree required.
• 10 or more 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.
• More than 5 years of direct experience working with CMS, Medicare Administrative Contractors (MACs), MolDx, or other Medicare reimbursement and policy organizations.
• 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.

Nice To Haves

• An advanced degree such as MPH, MHA, PharmD, PhD, JD, MBA, or equivalent.
• Prior work at CMS.

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.

Benefits

• Variable cash program (bonus or commission) eligibility for all employees.
• Equity may be included for eligible roles.
• Access to genomics sequencing.
• Family planning benefits.
• Health, dental, and vision benefits.
• Retirement benefits.
• Paid time off.
• Employee Resource Groups offering career development experiences, cultural awareness, and social responsibility opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Director