Director of Market Access and Payer Strategy (West Coast)

About the role

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. The position is remote with up to 30% travel across the West Coast.

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.

Requirements

• 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

• 401K with match
• Health, Dental, Vision, LTD, and HSA
• 3 weeks PTO + 11 holidays

Pay

Salary: $160K - $180K plus performance bonus and equity