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Director, Payer Relations (Remote)
Job Description
Job Description
The Director, Payer Relations is responsible for leading the US Payer Relations team to achieve favorable coverage, coding, and reimbursement. This role oversees reimbursement strategy and execution across commercial payers, Medicare Administrative Contractors (MACs), and Medicaid within an assigned region, with a focus on ensuring appropriate payment, minimizing access barriers, and supporting utilization.
The Director leads and develops the team, ensuring effective coordination of reimbursement support for key opinion leader healthcare providers and institutional customers. The role partners closely with Patient Services to deliver consultative support addressing reimbursement challenges and collaborates cross?functionally with Sales, Market Access, Medical Affairs, Marketing, and Customer Relations to advance payer and provider strategies.
This position serves as a subject matter expert in payer policy and reimbursement, engaging regularly with commercial and government payer stakeholders, including medical directors, policy and provider relations teams, CMS MAC leadership, Medicaid agencies, and state and federal health organizations. The Director also builds relationships with advocacy groups, professional societies, and healthcare systems to establish sustainable access pathways for current and future technologies.
What Will You Do
- Lead and manage the team to develop and execute coverage and reimbursement strategies for national and regional commercial plans, Medicare, and Medicaid.
- Drive payer engagement to secure coverage for newly marketed products, resolve reimbursement challenges, and reduce barriers to patient access.
- Support KOL healthcare providers by addressing reimbursement needs in partnership with Sales and Market Access leadership.
- Establish and maintain strategic payer and stakeholder relationships to support long?term growth.
- Provide regular payer and reimbursement updates to senior leadership.
- Execute outreach with state and local provider, patient, and healthcare advocacy organizations.
- Travel approximately 50%.
- Bachelor’s degree required.
- 12+ years of industry experience, including at least 10 years in medical device, biotechnology, or pharmaceutical sectors.
- Minimum of 4 years of people management experience.
- At least 2 years of demonstrated payer leadership experience.
- Strong communication skills with the ability to articulate clinical value and reimbursement strategy.
- Proven leadership, relationship management, and cross?functional collaboration skills.
- Strong organizational, operational, and budget management capabilities.
- Experience with patient management programs.
- Familiarity with patient CRM systems.
- Prior call center experience.
Equal Opportunity Employer: We are proud to be an equal opportunity employer. We welcome and encourage applications from all qualified candidates regardless of race, sex, gender identity or expression, disability, age, religion or belief, sexual orientation, or any other characteristic protected by applicable laws and regulations. It is our policy not to discriminate against any applicant or employee, and we are committed to fostering a diverse, inclusive, and respectful work environment across all locations in which we operate. We believe that diversity, equity, and inclusion are fundamental to our mission and enhance our ability to serve clients globally. If you have a disability or require any reasonable accommodations during the application or interview process, please inform your recruiter or contact us directly so that we can explore the appropriate arrangements.
Fraud Alert: Candidate safety is a top priority at Planet Pharma. The industry has seen an increase in people falsely representing themselves as recruiters to gather personal information from job seekers. For your safety, do not provide sensitive data to anyone you have not spoken with thoroughly, never provide banking information during the application process and always double check the email address of the Recruiter to ensure it’s from an official Planet Pharma domain (@planet-pharma.com, @planet-pharma.co.uk, and @ppgadvisorypartners.com) and not a domain with an alternative extension like .net, .org or .jobs.
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