Director, Commercial Reimbursement
New
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 in health policy, health services administration, or public health preferred.
- Minimum 8 years of progressively responsible experience in reimbursement, market access, or payer relations within medical devices or healthcare.
- Experience working with commercial health plans, including policy review, coverage advocacy, and negotiations.
- Strong working knowledge of commercial health plan prior authorization, claims processing, and appeals.
- Experience working with commercial payer data sources and claims datasets.
- Familiarity with coding, payment, and site-of-service considerations.
- Prior people management experience.
- Strong technical, written, and communication skills.
- Ability to travel up to 40%.
- Willingness to maintain hospital credentialing requirements.
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 and 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.
- Manage the Market Access Manager team, setting performance expectations and coaching.
- Establish standardized reimbursement processes and best practices.
- Collaborate cross-functionally with Commercial, Sales, Medical, Legal, and Finance teams.
- Develop metrics to assess reimbursement performance and identify risks.
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