Director - Medical Policy
Caris Life Sciences
June 30, 2026
Remote friendly (United States)
United States
Medical Affairs
Position Summary
- The Director of Medical Policy will manage Market Access strategies for current and pipeline products and drive payer and health policy initiatives for the Caris Life Sciences product portfolio.
- Lead tactics and communications to influence reimbursement policies, including coverage and evidence generation for current and pipeline products.
- Identify, analyze, and respond to medical policy developments for commercial and government payers and Lab Benefit Management (LBM) companies.
Job Responsibilities
- Monitor/analyze payer and LBM medical policies, coverage decisions, and reimbursement trends.
- Interpret payer/policy changes and communicate implications to internal stakeholders.
- Serve as clinical/product expert; present clinical data to medical policy decision-makers.
- Own/support evidence generation plans, value propositions, and technical submission packages for payer/LBM coverage.
- Engage payer stakeholders; advocate for coverage of Caris tests; maintain policy relationships.
- Support national/state legislative initiatives for coverage of evidence-based biomarkers.
- Track professional society guidelines and technology assessments influencing payer policy.
- Develop payer engagement strategies; lead internal training; report KPIs.
- Collaborate with Clinical Development and HEOR to align evidence generation with payer expectations.
- Support pricing strategy insights; represent the company at external policy forums.
Required Qualifications
- Advanced clinical/scientific degree (e.g., PharmD, PhD, MS, NP, PA or equivalent).
- 7+ years in medical policy/market access or related roles.
- Experience engaging payers (Medical Directors/policy decision-makers).
- Strong knowledge of U.S. reimbursement (CMS and commercial).
- Evidence-based value proposition development; strong analytics/communication.
- Cross-functional experience in matrixed organizations.
- Deep oncology biomarker/companion diagnostic expertise.
- Understanding of digital health and real-world evidence (RWE).
Preferred Qualifications
- 10+ years market access/medical affairs/payer engagement; 5+ years reimbursement experience (biotech/device/molecular diagnostics).
- Experience with LBMs and HTAs; RWE/digital health familiarity.
- Leadership/strategic advisory experience; policy advocacy/working group participation.
- Scientific expertise in Comprehensive Genomic Profiling.
Benefits
- Highly competitive medical, dental, and vision coverage; Health Savings Account; Flexible Spending Account; Paid time off; 401k match; LTD/STD and voluntary benefits; Employee Assistance Program; Pet Insurance; Legal Assistance; Tuition Assistance.
Other
- ~25% travel; flexible hours when required.
- The Director of Medical Policy will manage Market Access strategies for current and pipeline products and drive payer and health policy initiatives for the Caris Life Sciences product portfolio.
- Lead tactics and communications to influence reimbursement policies, including coverage and evidence generation for current and pipeline products.
- Identify, analyze, and respond to medical policy developments for commercial and government payers and Lab Benefit Management (LBM) companies.
Job Responsibilities
- Monitor/analyze payer and LBM medical policies, coverage decisions, and reimbursement trends.
- Interpret payer/policy changes and communicate implications to internal stakeholders.
- Serve as clinical/product expert; present clinical data to medical policy decision-makers.
- Own/support evidence generation plans, value propositions, and technical submission packages for payer/LBM coverage.
- Engage payer stakeholders; advocate for coverage of Caris tests; maintain policy relationships.
- Support national/state legislative initiatives for coverage of evidence-based biomarkers.
- Track professional society guidelines and technology assessments influencing payer policy.
- Develop payer engagement strategies; lead internal training; report KPIs.
- Collaborate with Clinical Development and HEOR to align evidence generation with payer expectations.
- Support pricing strategy insights; represent the company at external policy forums.
Required Qualifications
- Advanced clinical/scientific degree (e.g., PharmD, PhD, MS, NP, PA or equivalent).
- 7+ years in medical policy/market access or related roles.
- Experience engaging payers (Medical Directors/policy decision-makers).
- Strong knowledge of U.S. reimbursement (CMS and commercial).
- Evidence-based value proposition development; strong analytics/communication.
- Cross-functional experience in matrixed organizations.
- Deep oncology biomarker/companion diagnostic expertise.
- Understanding of digital health and real-world evidence (RWE).
Preferred Qualifications
- 10+ years market access/medical affairs/payer engagement; 5+ years reimbursement experience (biotech/device/molecular diagnostics).
- Experience with LBMs and HTAs; RWE/digital health familiarity.
- Leadership/strategic advisory experience; policy advocacy/working group participation.
- Scientific expertise in Comprehensive Genomic Profiling.
Benefits
- Highly competitive medical, dental, and vision coverage; Health Savings Account; Flexible Spending Account; Paid time off; 401k match; LTD/STD and voluntary benefits; Employee Assistance Program; Pet Insurance; Legal Assistance; Tuition Assistance.
Other
- ~25% travel; flexible hours when required.