Director, Payer Policy & Health Outcomes

Scipher Medicine develops innovative diagnostic tests to determine drug response and targeted therapies using its proprietary personalized medicine platform based on molecular technology. Our platform allows us to interpret genomic data to gain unique insights into disease biology so patients with even the most complex diseases can achieve optimal health outcomes.

With only about 1 out of 3 patients adequately responding to anti-tumor necrosis (anti-TNF) therapies, the world’s largest selling drug class, we developed our flagship test, PrismRA™, to predict response to these drugs, thereby ensuring patients receive the most effective therapies from day one. Scipher is transforming the traditional diagnostics business model by working closely with payers to change the way medications will be prescribed, saving both insurers and patients billions wasted in ineffective prescription costs. This is a unique opportunity to join a promising venture at an early stage to tackle some of the biggest problems in healthcare.

We are proud of our passionate, high-performance, mission-driven culture – one based on a set of values that are the cornerstone of who we are and how we hold ourselves accountable. Founded in 2015, we are based in Waltham, MA and currently expanding across all functions within the organization. We are backed by Khosla Ventures, Northpond Ventures, Alumni Ventures and Tachyon Ventures, and are well capitalized to execute our vision of launching a personalized medicine platform that transforms patients’ lives. Check us out at and follow us on LinkedIn.

The Role: The Director, Payer Policy and Health Outcomes will work specifically in the reimbursement/health insurance space.  They will support the market access team build scientific/clinical relationships with internal and external stakeholders, and further the reimbursement effort by collating existing data and informing the development of new data to support initial and ongoing value-based reimbursement of Scipher’s Product Portfolio.

Where: Waltham, MA

What will I do?
– Responsible for clinical and scientific content of documents directed toward payers and the broader reimbursement audience
– Assist in the design of clinical utility and health economic studies and in the writing of subsequent manuscripts
– Travel with the market access team to payer audiences to present the clinical/scientific aspects of the Scipher Medicine product line
– Serve as a point person between the market access team and the clinical/scientific/commercial functions of the company
– Ensure clinical messaging for payers is well aligned with sales and marketing efforts
– Take on and complete specific tasks related to payer projects, including but not limited to, payer “pilots” or demonstration projects
– Engage with Health Technology Assessment organizations (e.g. BCBSA Evidence Street, ECRI, etc.) and/or Professional Guideline Organizations (e.g. ACR) to increase the positive assessments of Scipher Medicine testing

Minimum Education and Qualifications:
– Advanced degree (PhD, PharmD, RN, MS, CGC)
– Minimum of 5 years’ experience working with payers to review, draft and implement medical policies supporting value-based coverage and payment for advanced molecular diagnostics, and/or companion diagnostic products (i.e. precision or personalized medicine).
– Exceptional scientific writing capabilities and experience writing manuscripts, medical policies, dossiers, and other relevant documents.
– Ability to understand and clearly articulate advanced medical/scientific concepts (e.g., cancer genomics) at a level where they can be effectively understood payers.
– Successful experience building a positive and innovative clinical and health economic value proposition with payers
– Outgoing personal style and proven ability to build and maintain relationships with multiple levels at payers and related organizations (e.g. tech assessment, care management, employers, specialty pharmacy, patient advocacy, etc.)
– Understanding of the rheumatology clinical “landscape” (e.g., how treatment decisions are made across all patient types).
– Project management of clinical trials or payer-related coverage “pilots” or demonstration projects.
– 30% travel required
– Established payer relationships a plus.
– Successful track record working in fast-paced, growing organization preferred.
– Ability to laugh at yourself

To all recruitment agencies: Scipher Medicine does not accept agency resumes. Please do not forward resumes to our jobs alias, or Scipher Medicine employees. Scipher Medicine is not responsible for any fees related to unsolicited resumes.

Scipher Medicine is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.  Scipher will make reasonable accommodations for qualified individuals with known disabilities, in accordance with applicable law.