Director, Market Access – Reimbursement Strategy

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead the U.S. market access, coverage, and reimbursement strategy for Saluda.

• Take ownership of, manage, and continually enhance the Smart Access Reimbursement program.

• Supervise prior authorization support, develop appeals strategies, conduct benefit investigations, and manage case escalation pathways.

• Establish key performance indicators for the program and report on approval rates, turnaround times, and denial overturn rates to commercial leadership.

• Oversee relationships with vendors and hub services while providing training for field teams and provider offices.

• Act as the escalation point for complex access cases and emerging payer challenges.

• Create and implement national and regional payer strategies for SCS and closed-loop therapy.

• Monitor and influence CPT/HCPCS, DRG/APC, physician fee schedules, as well as coverage and payment dynamics across commercial, Medicare, and Medicaid channels.

• Track and respond to developments in CMS policies, including the Ambulatory Specialty Model and other value-based initiatives.

• Lead frameworks for value-based and shared-risk contracting using Evoke's objective ECAP data.

• Convert clinical and real-world evidence into payer-facing value dossiers, objection handlers, and coverage advocacy materials.

• Assist with medical policy engagement, technology assessments, draft policy responses, and interactions with payers advisory groups.

• Cultivate relationships with medical societies to promote coverage advocacy, coding initiatives, and clinical guideline development.

• Provide Sales and field reimbursement resources with tools for access conversations, training, and messaging.

• Collaborate across functions with Marketing, Sales, Therapy Awareness, Clinical, Regulatory, and Finance teams.

• Develop and mentor market access talent while managing direct reports or contracted field reimbursement resources as assigned.

• Represent Saluda in discussions with professional societies, coalitions, and industry groups regarding reimbursement and policy issues.

⛳️ Requirements

• A bachelor's degree is required.

• An advanced degree (MBA, MPH, MHA, JD) is preferred.

• Over 10 years of progressive experience in medical device market access, reimbursement, or payer strategy.

• Experience in neuromodulation, spine, or interventional pain is strongly preferred.

• Proven success in managing a reimbursement support/hub-services program, including vendor oversight and KPI management.

• Extensive working knowledge of U.S. coding, coverage, and payment systems across hospital outpatient, ASC, and physician office settings.

• Experience in engaging payers directly regarding medical policy, coverage expansion, and contracting.

• Familiarity with CMS payment models and trends in value-based care.

• Strong skills in cross-functional leadership and executive communication.

• Experience launching or defending coverage for a novel Class III device or breakthrough technology is preferred.

• Previous involvement in value-based or risk-sharing agreements utilizing device-generated objective data is preferred.

• Established relationships with payers and specialty societies in the pain management field are preferred.

🏝️ Benefits

• Full-time employment.

• Equal opportunity employment.

• Commitment to diversity and inclusion.