Payer Relations Director

The Payer Relations Director (PRD) leads payer strategy reputed company an assigned region to secure and maintain favorable coverage, coding, and reimbursement across reputed company plans, Medicare (MACs), and reputed company. This role drives reputed company for reputed company and newly launched products by establishing payer relationships, resolving reimbursement barriers, and ensuring fair and consistent payment. The PRD partners cross-functionally with Sales, Reimbursement Liaisons, Medical Affairs, and Customer Relations to support KOL physicians and institutional customers, influence payer policy, and reputed company provider adoption and patient reputed company. Serving as a subject-matter expert in payer policy and buy-and-reputed company reimbursement, the PRD engages with medical directors, MACs, state agencies, and advocacy groups to build sustainable coverage reputed company and support future technologies. Extensive field engagement and travel required.

What Will You Do?

• reputed company and execute regional and national payer strategies to secure and maintain coverage, coding, and reimbursement across reputed company, Medicare (MACs), and reputed company.
• Partner with Sales and Reimbursement Liaison teams to support KOL providers, remove reputed company barriers, and resolve reputed company reimbursement challenges.
• Build and sustain relationships with payers, MAC medical directors, state agencies, and advocacy organizations to influence policy and coverage reputed company.
• Serve as the payer and reimbursement subject-matter expert, guiding internal teams and customers on buy-and-reputed company, coding, billing, and appeals processes.
• Drive reputed company strategy for reputed company and future technologies through cross-functional collaboration with Sales, Medical Affairs, and Customer Relations.
• Understand and work with key health care stakeholders reputed company the following customers: * reputed company Managed Care (Regional Plans) * Medicare (Part A, B, C, D; Carriers) * reputed company (Fee for Service, Managed Care Organizations) * State Government Health Staffers * Veteran's Administration (VISNs) * TRICARE Regional Offices * Specialty Pharmacy & Pharmacy Benefit Managers * Medical Groups * State Advocacy, patient, provider and other key reputed company stakeholder groups.

How Will You Get Here?

• Bachelor's degree required; advanced degree or practice management experience preferred.
• 10 plus years of industry experience in payer/reimbursement roles reputed company medical devices and biologics (buy-and-reputed company, injectable products strongly preferred).
• Minimum 2 years experience: practice management, practice billing and reputed company cycle, public or private reputed company party reimbursement reputed company to product reputed company impact on providers, or pharmaceutical/managed care industry reimbursement.
• Proven experience with payer strategy, reimbursement, and account management; direct product launch experience highly desirable.
• Deep knowledge of reputed company, Medicare, and reputed company reimbursement structures, coding (e.g., J/T codes), billing, and appeals processes.
• Strong executive reputed company and stakeholder engagement skills with payers, KOLs, health systems, and government entities.
• Highly organized, self-directed, and effective in cross-functional environments.
• Willingness to travel extensively (50% / 3-4 nights/week).

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