Director, Commercial Reimbursement
New
C
CalyxoMedical Devices
Remote, USAFull-TimeDirector
Salary210,000 - 225,000 USD per year
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Job Details
- Experience
- Minimum 8 years
- Required Skills
- Data AnalysisPeople Management
Requirements
- Bachelor’s degree required; advanced degree preferred in health policy, health services administration, or public health.
- Minimum 8 years of progressively responsible experience in reimbursement, market access, or payer relations.
- Demonstrated experience working with commercial health plans, policy review, and coverage advocacy.
- Working knowledge of commercial health plan prior authorization and claims processing.
- Experience using commercial payer data sources and claims datasets.
- Familiarity with coding, payment, and site-of-service considerations.
- Prior people management experience with accountability for team performance.
- Ability to effectively interact with multiple departments.
- Strong oral, written, and communication skills.
- Proficiency with Microsoft Office software.
Responsibilities
- Develop and execute commercial reimbursement strategies aligned with company objectives.
- Lead engagement with national, regional, and local commercial health plans.
- Drive efforts to influence or revise commercial payer medical policies.
- Lead escalation of payer policy disputes and coverage barriers.
- Serve as primary contact for payer negotiations and senior-level escalations.
- Provide direct people management and leadership for the Market Access Manager team.
- Establish standardized processes and best practices for reimbursement operations.
- Collaborate with cross-functional teams to ensure integrated reimbursement planning.
- Develop metrics and reporting to assess reimbursement performance and risk.
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