Director of Market Access - Payer Engagement

March 1

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PRIAevents

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PRIAevents is a company that organizes events and conferences, featuring speakers from various fields. They provide opportunities for career growth and actively engage in sharing knowledge through their events. Their platform aims to enhance the experience of attendees and speakers alike, ensuring informative and valuable interactions.

event management • PR • Marketing

2 - 10 employees

🤝 B2B

📚 Education

📋 Description

• Lead and support specific payer engagement initiatives, leveraging existing relationships to influence policy development and reimbursement strategies across national and regional commercial payers, integrated delivery networks, independent physician associations, and Government payers. • Develop and execute market access strategies to ensure favorable reimbursement and coverage for clients' medical technologies. • Collaborate with PRIA’s Market Access team to develop and communicate strategic plans, tactics, and payer engagement initiatives. • Establish and strengthen relationships with key opinion leaders (KOLs) and influential stakeholders within payer organizations and the MedTech community. • Work cross-functionally with PRIA’s Reimbursement, Health Economics, and Market Access teams to ensure comprehensive strategy execution. • Analyze and present data-driven insights, identifying trends and ensuring programs align with client goals. • Manage administrative tasks associated with overseeing a portfolio of clients.

🎯 Requirements

• Bachelor’s degree required; advanced degree preferred. • 10+ years of experience in U.S. reimbursement and market access, preferably in a consulting, HUB services, or MedTech environment. • Strong expertise in coding constructs (HCPCS, CPT, ICD-10) and their relation to coverage policies, utilization management guidelines, and claims adjudication. • Deep understanding of federal and state regulations related to medical reimbursement, including payment models for outpatient, inpatient, DME, and physician office settings. • Experience collaborating with internal teams (e.g., billing, coding, patient access programs) to resolve coding and coverage challenges. • Excellent communication and interpersonal skills, with the ability to confidently guide clients, articulate value propositions and clinical data to influence payer decision-making. • Demonstrated success in securing payer policies and contract terms that establish medical technology as medically necessary. • Strong analytical skills to interpret data, identify trends, and develop actionable insights. • Results-driven mindset, committed to exceeding client expectations and delivering measurable outcomes. • Problem-solving ability, with a proactive approach to identifying client challenges and recommending solutions. • Payer contracting experience preferred