Director, Market Access & Payer Strategy (West Coast)
Location: Remote with up to 30% travel across the West Coast
Salary: 160K - 180K plus performance bonus and equity
Intro: We're a cutting-edge DME that is looking for an East Coast Director of Market Access and Payer Strategy to lead the expansion of medical policy coverage, improve reimbursement access, establish in-network pathways, and build payer relationships across commercial health plans and Medicaid managed care. We're looking for someone with strong experience in driving payer access outcomes through relationship development, medical policy engagement, and payer contracting discussions.
Key Responsibilities:
Develop and execute a regional payer access and commercial execution strategy to achieve coverage, coding, and reimbursement objectives across the West Coast market. Lead payer contracting negotiations and in-network access initiatives with commercial payers, Medicaid Managed Care Organizations, and Medicare stakeholders to secure favorable terms and reimbursement pathways. Build and maintain strong relationships with payer executives, medical directors, clinical leaders, and key account decision-makers to drive coverage and utilization. Influence medical policy and clinical coverage decisions by presenting clinical and health economic evidence, real-world data, and value propositions to payers and provider groups. Partner with sales, reimbursement, clinical, and marketing teams to design account-level access plans, enable field teams with payer intelligence, and drive coordinated commercial execution. Manage payer access programs including prior authorization strategies, appeals processes, bundled payment strategies, and reimbursement support for Durable Medical Equipment (DME) and device solutions. Monitor and interpret payer policy trends, regulatory changes, and competitive access dynamics; translate insights into strategic recommendations and tactical plans. Support development of pricing, contracting templates, and value-based arrangements; evaluate financial impact and ROI of market access initiatives. Lead cross-functional projects and pilots with provider systems, IDNs, and payers to demonstrate outcomes, support coverage decisions, and scale access models. Mentor and develop regional access staff and act as a subject matter expert on payer strategy, managed care dynamics, and reimbursement best practices.
Qualifications:
Experience in payer access, market access, managed care, or reimbursement roles within DME or Medical Device. Demonstrated success negotiating payer contracts and securing coverage with commercial payers, Medicaid Managed Care, and Medicare programs.
Deep knowledge of payer landscape, including payer access, payer strategy, payer coverage, medical policy development, and reimbursement pathways for DME and medical devices.
Experience working with medical directors, payer executives, and clinical stakeholders to influence coverage and utilization decisions.
Proven ability to synthesize clinical and health economic evidence into compelling value propositions for payers and providers.
Experience with payer contracting, prior authorization processes, appeals, and in-network access strategy.
Excellent cross-functional leadership, communication, and stakeholder management skills with a track record of partnering with sales and clinical teams to drive commercial outcomes.
Ability to travel across the East Coast and work collaboratively with remote regional teams.
Benefits:
Performance BonusEquity 401K with match Health, Dental, Vision, LTD, and HSA3 weeks PTO + 11 holidays
