#298 Genetic Counselors Role in Insurance with Stephanie Gandomi

Did you know genetic counselors can work for medical insurance companies?    Stephanie Gandomi was one of the first! She is a licensed and board-certified genetic counselor with over 20 years of experience in medical genomics including patient care, research, industry, insurance, education, and more. Currently, she serves as the Program Director of the Master of Science in Genetic Counseling at Southern California University of Health Sciences. Her previous roles in insurance include being the first genetic counselor at Blue Shield of California and the Director of Genetics at UnitedHealthcare. In this conversation, we'll explore how genetic counselors can have a huge impact working for medical insurance companies.   Also shout out to Rebecca C for recommending this topic as Stephanie the perfect guest! She saw Stephanie present on a GC Prep webinar. GC Prep does fantastic work helping students with the genetic counseling graduate program application process. GC Prep is a past sponsor and you can check out appearances by their team members in Episodes #193, #194 and others.    Stephanie Gandomi is a board certified, licensed genetic counselor. She earned her Master of Science in genetic counseling at Brandeis University in 2006 and her MBA from Boise State University in 2019. She started her clinical career at Lucile Packard Children's Hospital at Stanford, and has been in the molecular genetics space now for over 20 years. In 2016, Stephanie became the first genetic counselor in the Blue Cross Blue Shield System of payers as the Principal Program Manager for precision medicine at Blue Shield of California. In 2016, Stephanie became the Director of Genetics at UnitedHealthcare supporting prior authorization and medical policy creation for genetics, and has served as the Director of Market Access at both Ambry Genetics and GeneDx. She is currently the Program Director for the new Master of Science in Genetic Counseling Program at Southern California University of Health Sciences. Stephanie is an AAPC Certified Professional CPT Coder and an AAPC Certified Professional Compliance Officer. She is currently pursuing her Juris Doctor degree with an emphasis in healthcare law and regulatory compliance. On This Episode We Discuss:   Transition to the Insurance Industry Motivation behind moving from clinical genetic counseling to the medical insurance sector. The unique perspective and skills that genetic counselors bring to insurance companies.   Role of Genetic Counselors in Insurance Importance of genetic counselors in developing and implementing medical policies within insurance firms. Strategies for effectively educating insurance companies about the value and necessity of genetic testing.   Achievements and Challenges at Blue Cross Significant changes and innovations implemented at Blue Cross that led to cost savings and improved patient outcomes. Major challenges faced when advocating for genome sequencing coverage by insurance companies.   Balancing Cost and Access Strategies for balancing cost containment with ensuring patient access to essential genetic testing and services. Addressing common misconceptions insurance companies have about genetic testing and how these were tackled.   Future of Genetic Counselors in Insurance The evolving role of genetic counselors in the insurance industry over the next decade. Key skills and knowledge areas for genetic counselors interested in transitioning to the insurance sector.   Building Relationships with Payors Approaching the building of relationships and trust with major payors during industry tenure. Advice for genetic counselors on successfully advocating for patients in navigating insurance coverage for genetic tests.   Evolution of Counselor-Insurance Relationships Future relationship dynamics between genetic counselors and insurance companies aimed at better serving patients. Hopes for the future of genetic counseling and insurance coverage for genetic testing, and ways professionals can contribute to these goals.   Advice for Genetic Counselors and Students Guidance for genetic counselors interested in transitioning to roles within the insurance industry. Advice for prospective genetic counseling students applying to programs, highlighting the importance of the Boise GC program and the upcoming program at Southern California University of Health Science.   If you are a prospective genetic counseling student, the application for the SCU MSGC program opened this week here.    Stay tuned for the next new episode of DNA Today next Friday! New episodes are released every Friday. 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