Sr. Director - Market Access And Reimbursement - Interventional Dry Eye

About the role

The Sr. Director – Market Access & Reimbursement is responsible for supporting Sight Sciences’ products and portfolio in assigned geographic areas, including eye care clinics, strategic accounts, corporate accounts, eye care providers, and payers. This role ensures the development and execution of a Market Access Reimbursement strategy that provides fair and consistent payment and removes barriers in the reimbursement process. Leading a Payor Relations and Reimbursement team, this position supports field sales leadership by developing and coordinating strategies for payers, eye care providers, nurses, billing staff, and administrators. The role serves as an expert in payer reimbursement policies to facilitate appropriate patient and provider access to care.

Under the direction of the VP of Commercial Business Unit, this role collaborates with Marketing, Sales, Professional Advocacy, Medical Affairs, R&D, and Clinical teams to ensure market access and competitive advantage for Sight Sciences products by integrating health economics, outcomes research, and market access solutions across all stages of the product lifecycle.

Responsibilities

• Build and lead a successful Payor Relations and Reimbursement team while holding field responsibilities.
• Support the team to be internal experts that advise, teach, coach, and build support material for internal and external customers on coding, coverage, billing, and reimbursement.
• Engage with key payers within the geographic region to ensure coverage and reimbursement of company technologies and develop relationships to support future pipeline needs.
• Develop payor strategy and dissemination plans to support national and regional needs.
• Lead customer-facing reimbursement and market access needs across the U.S. in collaboration with sales.
• Deliver presentations to national and regional payers to establish and/or improve reimbursement coverage policies, coding, and payment assignments.
• Promote reimbursement support and represent the company to external customers through writing, phone calls, visits, hosting, and participation in events.
• Serve as a content expert when representing the company with internal and external customers.
• Build programs to engage economic stakeholders, including payers and providers, expanding access to care.
• Evaluate incoming requests from the field for feasibility, technical risk, cost, time constraints, compliance, and other relevant considerations.
• Partner with internal and external stakeholders to ensure patient-reported outcomes, economic endpoints, and other evidence are included in trials to support economic modeling and value assessments.
• Work closely with Regional & National Sales Leadership to inform commercial strategy and support healthcare providers with their reimbursement needs.
• Network with regional, state providers, patient, and healthcare systems advocacy organizations.
• Evaluate and provide strategic direction on external/internal Sight Access Portal needs and execution.
• Develop sustainable corporate relationships to allow for continued growth of current and future products.
• Carry out all duties and responsibilities in accordance with Company policies, procedures, and applicable laws and regulations.

Qualifications

Education

• Bachelor’s degree in a HEMA-related discipline (health economics, outcomes research, or healthcare-related field) preferred.
• Master’s degree in a related field preferred.

Experience

• A minimum of 12 or more years’ experience in a highly regulated field and a minimum of 5 or more years in commercial medical device, pharmaceutical, or consulting business preferred.
• A proven record in building and leading successful teams.
• Strong business acumen, analytical skills, and experience working with various internal business partners (Sales, Marketing, Clinical, Regulatory, Legal, Compliance, and Government Affairs).
• Understanding of key public and private payer policy infrastructure, payment methodologies, coding, coverage, health policy trends, and current business challenges.
• Previous experience in, or strong working knowledge of, the medical device industry, especially in health economics and reimbursement planning and program implementation.
• Experience working with external stakeholders such as payers, hospitals, physicians, trade associations, and professional/medical organizations to develop mutually beneficial health economics and reimbursement strategies.
• Ability to work independently from strategy development to execution with multiple stakeholder types.
• Solid knowledge of evidence needed to drive favorable U.S. reimbursement and market access.

Other Qualifications

• A track record of success in evidence-based medicine, market development, health economics, reimbursement, or health policy.
• Strong understanding of U.S. reimbursement systems and market access trends.
• Ability to communicate clearly and concisely to large audiences; detail-oriented, self-motivated, and ability to work independently.
• Ability to take evidence and other complex data and package it into easy-to-understand deliverables for commercial use.
• Intellectual interest in keeping abreast of market access and reimbursement trends.
• Solution-oriented, with the ability to offer creative options for problem-solving.
• Work closely with multiple cross-functional partners, including Marketing, Sales, Professional Advocacy, Medical Affairs, Clinical Research, Regulatory Affairs, R&D, and Legal/Compliance.

Physical Demands

• Sitting for extended periods of time; regularly works in an office environment as well as meetings at physician offices, hospitals, and payers as required.
• Interacts with external customers such as healthcare providers and economic decision-makers to describe the value proposition of the company’s technology.
• Interacts with U.S. government payers (CMS), commercial payers, and medical societies on reimbursement and market access topics related to company technology.

Travel Requirements

Up to 30% domestic travel expected.