Sr. Manager, Reimbursement Operations & Optimization

<div class="content-intro"><p>At Veracyte, we offer exciting career opportunities for those interested in joining a pioneering team that is committed to transforming cancer care for patients across the globe. Working at Veracyte enables our employees to not only make a meaningful impact on the lives of patients, but to also learn and grow within a purpose driven environment. This is what we call <em>the Veracyte way</em> – it’s about how we work together, guided by our values, to give clinicians the insights they need to help patients make life-changing decisions. </p> <p>Our Values:</p> <ul> <li><strong>We Seek A Better Way</strong>: We innovate boldly, learn from our setbacks, and are resilient in our pursuit to transform cancer care</li> <li><strong>We Make It Happen</strong>: We act with urgency, commit to quality, and bring fun to our hard work</li> <li><strong>We Are Stronger Together</strong>: We collaborate openly, seek to understand, and celebrate our wins</li> <li><strong>We Care Deeply</strong>: We embrace our differences, do the right thing, and encourage each other</li> </ul> <p> </p></div><h3><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">The Position:</span></h3> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span class="NormalTextRun SCXW72042063 BCX0">We are </span><span class="NormalTextRun SCXW72042063 BCX0">seeking</span><span class="NormalTextRun SCXW72042063 BCX0"> a highly skilled and experienced Senior Manager, Reimbursement </span><span class="NormalTextRun SCXW72042063 BCX0">Operations</span><span class="NormalTextRun SCXW72042063 BCX0"> & </span><span class="NormalTextRun SCXW72042063 BCX0">Optimization </span><span class="NormalTextRun SCXW72042063 BCX0">to lead high</span><span class="NormalTextRun SCXW72042063 BCX0"> </span><span class="NormalTextRun SCXW72042063 BCX0">impact initiatives that improve financial </span><span class="NormalTextRun SCXW72042063 BCX0">& operational </span><span class="NormalTextRun SCXW72042063 BCX0">performance across the revenue cycle. In partnership with operational leaders, this role will be focused on designing, implementing, and scaling end</span><span class="NormalTextRun SCXW72042063 BCX0"> </span><span class="NormalTextRun SCXW72042063 BCX0">to</span><span class="NormalTextRun SCXW72042063 BCX0"> </span><span class="NormalTextRun SCXW72042063 BCX0">end reimbursement</span><span class="NormalTextRun SCXW72042063 BCX0"> processes</span><span class="NormalTextRun SCXW72042063 BCX0"> to drive sustainable improvements in reimbursement (</span><span class="NormalTextRun SCXW72042063 BCX0">i.e., improve ASP </span><span class="NormalTextRun SCXW72042063 BCX0">through</span><span class="NormalTextRun SCXW72042063 BCX0"> </span><span class="NormalTextRun SCXW72042063 BCX0">reducing initial denial rate</span><span class="NormalTextRun SCXW72042063 BCX0">, appeal </span><span class="NormalTextRun SCXW72042063 BCX0">efficacy</span><span class="NormalTextRun SCXW72042063 BCX0">, </span><span class="NormalTextRun SpellingErrorV2Themed SCXW72042063 BCX0">etc</span><span class="NormalTextRun SCXW72042063 BCX0">)</span><span class="NormalTextRun SCXW72042063 BCX0"> a</span><span class="NormalTextRun SCXW72042063 BCX0">nd operational efficiency.</span></span></p> <p><span class="NormalTextRun SCXW72042063 BCX0" style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Success in this role requires deep expertise in medical reimbursement systems and processes (e.g., utilization management, adjudication, and operational systems), along with strong knowledge of payor claim and medical policies to optimize reimbursement. Analytical, interpersonal, and operational skills are critical to streamlining processes and improving financial performance. A solid understanding of payor claim and appeal review processes—particularly from a claim processing and medical policy perspective—will also be essential to driving effective process improvements.</span></p> <ul> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Regularly analyze revenue cycle data to gauge and optimize operational performance; use data to identify reimbursement leakage and variability to maximize payor performance and operational outcomes.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Design scalable, system-based solutions to address root causes rather than symptoms in a way that will measurably improve operational effectiveness and claims performance.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Produce clear problem statements, process maps, business requirements, success metrics, and post implementation performance reviews to address root causes.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Monitor & track Payor Performance to maximize reimbursement, partnering with internal operations leaders on reviews (i.e., met coverage policies), remediations and payor escalations (if/when needed).</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Leverage data to identify trends, forecast impact, and prioritize high</span><span data-contrast="auto">‑</span><span data-contrast="auto">ROI initiatives, delivering clear, insights and recommendations to senior leadership & cross-functionally.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Take a proactive role in evaluating and implementing revenue cycle technologies (OCR, AI-Enabled workflows, integrations, automations, et al.) to enhance operational effectiveness</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Play a key role in revenue cycle technology initiatives, helping translate operational needs into requirements, partnering with technical teams in design and build, ensuring successful UAT to maximize production readiness and owning the creation of business documentation (requirements, process flows, UAT artifacts)</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Partner with Reimbursement leaders to re</span><span data-contrast="auto">‑</span><span data-contrast="auto">engineer reimbursement workflow to standardize processes while preserving flexibility for payor</span><span data-contrast="auto">‑</span><span data-contrast="auto">specific nuances.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;" data-contrast="auto">Drive cross functional workstreams across finance, operations, clinical teams, and Customer Care, to optimize revenue cycle performance. </span></li> </ul> <h3><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Who You Are:</span></h3> <ul> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">8+ years of experience in healthcare reimbursement, revenue cycle operations, or related financial operations, with progressive leadership responsibility.</span></li> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Demonstrated success driving process improvement and reimbursement optimization initiatives with measurable financial impact.</span></li> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Strong understanding of payor dynamics, prior authorization, claims adjudication, denials, and appeals.</span></li> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Experience leading or partnering with automation, AI, or technology enabled operational transformations.</span></li> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Advanced analytical skills with the ability to translate complex data into actionable insights.</span></li> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Proven ability to lead cross functional initiatives in a fast paced, ambiguous environment.</span></li> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Excellent analytical skills with the ability to analyze complex data, identify trends, and make data-driven decisions. <span data-ccp-props="{}"> </span></span></li> <li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;" data-ccp-props="{}">Experience building a strong team. Knows how to screen, hire, and coach new team members during periods of high growth.</span></li> </ul> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Preferred Qualifications:</span></p> <ul> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Clinical Background (BSN, Genetic counseling, etc.) a plus but not required.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Experience in diagnostics, laboratory services, or complex reimbursement environments.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><span data-contrast="auto">Formal training or certification in Lean, Six Sigma, or process improvement methodologies.</span><span data-ccp-props="{"201341983":2,"335559739":0,"335559740":300}"> </span></span></li> <li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;" data-contrast="auto">Experience building early indicator KPI models that forecast long-term reimbursement outcomes.</span></li> </ul> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"> #LI-Remote</span></p><div class="content-pay-transparency"><div class="pay-input"><div class="description"><p></p> <p class="x_MsoNormal"><span data-olk-copy-source="MessageBody">The final salary offered to a successful candidate will be dependent on several factors that may include but are not limited to years of experience, skillset, geographic location, industry, education, etc. Base pay is one part of the Total Package that is provided to compensate and recognize employees for their work, and this role may be eligible for additional discretionary bonuses/incentives, and restricted stock units.</span></p></div><div class="title">Pay range</div><div class="pay-range"><span>$130,000</span><span class="divider">—</span><span>$145,000 USD</span></div></div></div><div class="content-conclusion"><p> </p> <h3><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">What We Can Offer You</span></h3> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Veracyte is a growing company that offers significant career opportunities if you are curious, driven, patient-oriented and aspire to help us build a great company. We offer competitive compensation and benefits, and are committed to fostering an inclusive workforce, where diverse backgrounds are represented, engaged, and empowered to drive innovative ideas and decisions. We are thrilled to be recognized as a 2024 Certified™ Great Place to Work<sup>®</sup> in both the US and Israel - a testament to our dynamic, inclusive, and inspiring workplace where passion meets purpose.</span></p> <p> </p> <h3><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">About Veracyte</span></h3> <p>Veracyte (Nasdaq: VCYT) is a global diagnostics company whose vision is to transform cancer care for patients all over the world. We empower clinicians with the high-value insights they need to guide and assure patients at pivotal moments in the race to diagnose and treat cancer. Our Veracyte Diagnostics Platform delivers high-performing cancer tests that are fueled by broad genomic and clinical data, deep bioinformatic and AI capabilities, and a powerful evidence-generation engine, which ultimately drives durable reimbursement and guideline inclusion for our tests, along with new insights to support continued innovation and pipeline development. For more information, please visit <a href="https://cts.businesswire.com/ct/CT?id=smartlink&url=https%3A%2F%2Fwww.veracyte.com%2F&esheet=54340020&newsitemid=20251015446872&lan=en-US&anchor=www.veracyte.com&index=5&md5=4d48386b00ece1531372e2e593d7cd2d">www.veracyte.com</a> or follow us on <a href="https://cts.businesswire.com/ct/CT?id=smartlink&url=https%3A%2F%2Fwww.linkedin.com%2Fcompany%2Fveracyte%2F&esheet=54340020&newsitemid=20251015446872&lan=en-US&anchor=LinkedIn&index=6&md5=234cba826cb637f449d2722139f551ef">LinkedIn</a> or <a href="https://cts.businesswire.com/ct/CT?id=smartlink&url=https%3A%2F%2Fx.com%2Fveracyte%3Fs%3D11&esheet=54340020&newsitemid=20251015446872&lan=en-US&anchor=X+%28Twitter%29&index=7&md5=20ead95735af622bf261b20735515b66">X (Twitter)</a>.</p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Veracyte, Inc. is an Equal Opportunity Employer and will consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability status. Veracyte participates in E-Verify in the United States. View our <a href="https://www.veracyte.com/privacy-statement-for-california-residents/" target="_blank">CCPA Disclosure Notice</a>.</span></p> <p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong><span class="ui-provider a b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak">If you receive any suspicious alerts or communications through LinkedIn or other online job sites for any position at Veracyte, please exercise caution and promptly report any concerns to <a class="fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn" href="mailto:careers@Veracyte.com" target="_blank">careers@veracyte.com</a></span></strong></span></p></div>