Senior Clinical Payer Policy Analyst

About the Role:

The Senior Clinical Payer Policy Analyst serves as a subject matter expert and strategic leader in shaping reimbursement policy for Guardant Healths precision oncology portfolio. This role will directly influence payer engagement strategies ensure clinical evidence is translated effectively into coverage policies and proactively guide appeals and external review processes. The Senior Analyst will partner with internal leadership and external stakeholders to expand patient access to next-generation sequencing (NGS) and other advanced diagnostics.

You will play a pivotal role in aligning payer policy with evolving clinical standards providing guidance to internal teams and driving forward reimbursement initiatives that impact Guardants long-term growth and patient outcomes.

Essential Duties and Responsibilities:

• Lead analysis of payer coverage policies identifying trends gaps and opportunities across Medicare Medicaid and commercial payers
• Provide strategic recommendations to influence payer coverage criteria for advanced diagnostics
• Oversee complex appeals serving as an escalation point for challenging payer denials and external reviews
• Collaborate with internal appeals teams to strengthen rebuttals and ensure clinically robust submissions
• Partner with senior leadership on payer engagement strategies and interactions with Independent Review Organizations (IROs) and regulatory agencies
• Serve as a clinical reimbursement liaison across medical affairs regulatory commercial and client services teams
• Train mentor and provide guidance to appeals and reimbursement staff on clinical evidence and payer policies
• Conduct literature reviews data analyses and evidence development to support payer-facing strategies
• Anticipate and interpret regulatory and policy changes impacting reimbursement for oncology diagnostics
• Represent Guardant Health in payer policy and clinical forums as a subject matter expert
• Perform additional duties to support team goals and company initiatives

Qualifications :

• 57 years of experience in healthcare reimbursement clinical payer policy health economics or related fields
• Demonstrated success engaging with commercial and government payers including external reviews and state-level appeals
• Strong understanding of payer coverage frameworks laboratory billing and NGS reimbursement
• Advanced degree preferred (MS MPH CGC MSN PharmD MD or equivalent); clinical background strongly valued
• Proven expertise in clinical documentation appeal writing and payer policy interpretation
• Exceptional communication writing and presentation skills for payer and regulatory audiences
• Proficiency with Excel and data analysis tools; familiarity with payer portals and laboratory billing systems a plus
• Strong leadership organizational and problem-solving skills with the ability to manage multiple priorities
• Proactive and strategic thinker with a passion for improving patient access to innovative diagnostics

Additional Information :

Hybrid Work Model: At Guardant Health we have defined days for in-person/onsite collaboration and work-from-home days for individual-focused time. All U.S. employees who live within 50 miles of a Guardant facility will be required to be onsite on Mondays Tuesdays and Thursdays. We have found aligning our scheduled in-office days allows our teams to do the best work and creates the focused thinking time our innovative work requires. At Guardant our work model has created flexibility for better work-life balance while keeping teams connected to advance our science for our patients.

The US base salary range for this full-time position is $78710 to $108290. The range does not include benefits and if applicable bonus commission or equity. The range displayed reflects the minimum and maximum target for new hire salaries across all US locations for the posted role with the exception of any locations specifically referenced below (if any).

For positions based in Palo Alto CA or Redwood City CA the base salary range for this full-time position is $92600 to $127400. The range does not include benefits and if applicable bonus commission or equity.

Within the range individual pay is determined by work location and additional factors including but not limited to job-related skills experience and relevant education or training. If you are selected to move forward the recruiting team will provide details specific to the factors above.

Employee may be required to lift routine office supplies and use office equipment. Majority of the work is performed in a desk/office environment; however there may be exposure to high noise levels fumes and biohazard material in the laboratory environment. Ability to sit for extended periods of time.

Guardant Health is committed to providing reasonable accommodations in our hiring processes for candidates with disabilities long-term conditions mental health conditions or sincerely held religious beliefs. If you need support please reach out to 

Guardant Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin or protected veteran status and will not be discriminated against on the basis of disability.

All your information will be kept confidential according to EEO guidelines.

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