Healthcare Market Access Counsel

 

The Position

The Healthcare & Market Access Counsel serves as a senior legal advisor to the company’s Market Access, Reimbursement, and Commercial organizations, providing strategic counsel on complex healthcare, payer, reimbursement, and coverage matters. This role will lead the legal strategy supporting payer contracting and market access initiatives, applying significant independent judgment to navigate evolving regulatory requirements, reimbursement frameworks, and business priorities.

The Healthcare & Market Access Counsel will partner closely with senior business leaders and cross-functional stakeholders to shape payer and reimbursement strategies, identify and mitigate legal and business risk, and develop practical solutions that advance patient access to the company’s innovative diagnostic solutions. The successful candidate will combine deep healthcare legal expertise with strong business acumen and the ability to influence decisions across functions.

Key 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.
• · Embody company values by working collaboratively, embracing complexity, demonstrating accountability, and contributing to a culture of respect and innovation.

Who You Are

Required Qualifications

• · Juris Doctor (JD) from an accredited law school and active bar membership in good standing
• · 5+ years of relevant legal experience, including healthcare law, market access, or payer contracting
• · Experience reviewing and negotiating contracts with private payors, health plans, or managed care organizations
• · Strong understanding of U.S. healthcare reimbursement and coding systems, including commercial insurance and managed care structures, the MolDx program, AMA CPT codes, and the CLFS.
• · Demonstrated experience supporting or advising on appeals strategies, coverage disputes, or reimbursement challenges
• · Ability to translate complex legal and regulatory issues into clear, actionable guidance for business partners
• · Strong collaboration and communication skills, with a track record of working effectively across cross-functional teams
• · High level of integrity, sound judgment, and attention to detail

Preferred Qualifications

• · Experience in diagnostics, life sciences, or laboratory services environments
• · Familiarity with payer policy development, utilization management, or claims adjudication processes
• · Experience working closely with market access, billing, revenue cycle, or reimbursement teams
• · Knowledge of federal and state healthcare regulations impacting diagnostics and coverage (e.g., Medicare, Medicaid, and commercial frameworks)
• · Prior in-house experience in a growth-oriented healthcare or biotech organization or a commercial insurance company
• · Comfort navigating ambiguity and contributing to evolving processes in a dynamic, mission-driven environment

 

#LI-Onsite, #LI-Hybrid, or #LI-Remote

For candidates based in our San Diego office, the range is $160,00 - $206,700.

For candidates based in our South San Francisco office, the range is $167,000 - $216,500.

For REMOTE candidates, the range is $152,000- $196,000.