Location: [Insert location or remote status]
Travel: Up to 20% domestic
We are seeking a strategic and experienced Director of Payor Relations to lead efforts in coverage, coding, and reimbursement strategy for a portfolio of innovative medical technologies. This individual will drive engagement with commercial and government payors , advocate for favorable coverage decisions, and ensure broad patient access through compelling clinical and economic evidence.
This role is highly cross-functional, requiring close collaboration with Market Access, Health Economics & Outcomes Research (HEOR), Medical Affairs, Clinical, and Commercial teams to ensure product value is demonstrated and payer-aligned strategies are embedded throughout the product lifecycle.
Develop and execute payor engagement strategies to drive coverage, coding, and reimbursement across public and private payors.
Cultivate trusted relationships with Medical Directors, Policy Teams, and Chief Medical Officers at health plans and payer organizations.
Lead payer-facing presentations that convey clinical value, health economic evidence, and patient outcomes to support access.
Collaborate with internal HEOR, Clinical, and Medical Affairs teams to develop payer-facing materials (e.g., dossiers, value propositions, economic models).
Support CPT and HCPCS coding efforts , including submissions and cross-functional strategy in partnership with coding experts and societies.
Monitor changes in policy and reimbursement trends and proactively identify opportunities and risks for market access.
Partner with sales and field reimbursement teams to resolve local access barriers and support pull-through initiatives.
Contribute to pricing strategy and commercialization planning by forecasting reimbursement trends and payor adoption.
Serve as the internal "voice of the payer" , ensuring access considerations shape commercial strategy and product positioning.
Bachelorâs degree required; advanced degree in health economics, public health, or related field preferred.
8+ years in market access, payor relations, or reimbursement within the medical device, diagnostics, or biopharma industries.
Experience influencing payor policy development , especially within Medicare, Medicaid, and large commercial health plans .
Strong knowledge of CPT III/HCPCS coding, payment systems , and coverage pathways .
Demonstrated success in securing or improving coverage and reimbursement for novel technologies or procedures.
Skilled in translating complex clinical and economic data into clear, actionable messaging for payor stakeholders.
Experience in ophthalmology, surgical specialties , or similar high-specialty areas is preferred but not required.
Strong presentation, negotiation, and interpersonal skills.
Ability to work cross-functionally and independently in a fast-paced, evolving environment.
Experience navigating site-of-service reimbursement differences (ASC, HOPD, physician office).
Pre-existing relationships with payor medical directors, societies, or reimbursement consultants .
Familiarity with US healthcare policy trends and evolving value-based care models.
Leadership experience or team-building skills are a plus.
Hybrid or remote flexibility depending on candidate location.
Approximately 20% travel expected for payor meetings, conferences, or internal team collaboration
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