Director, Payer Relations

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

📋 Description

• Develop and implement U.S. payer engagement strategies to secure, expand, and maintain appropriate coding, coverage, payment, and patient access for both current and future medical technologies.

• Establish strategic partnerships with national and regional commercial health plans, Medicare stakeholders, Medicaid programs, Medicare Administrative Contractors, integrated delivery networks, and other payer decision-makers.

• Create payer account plans that align with portfolio, launch, and lifecycle priorities.

• Lead payer interactions focusing on medical policy, utilization-management criteria, coding, reimbursement, payment adequacy, network considerations, and patient-access challenges.

• Negotiate and implement payer agreements or value-based arrangements in collaboration with Legal, Finance, Compliance, and senior leadership.

• Monitor payer policies, coverage criteria, claims experiences, reimbursement pathways, policy review cycles, and developments at both federal and state levels.

• Develop action plans aimed at achieving favorable, evidence-based coverage and appropriate payment.

• Collaborate on strategies for Medicare, commercial, Medicaid, facility, and physician payments.

• Support engagement efforts with government entities, payers, and assessment organizations.

• Provide payer insights that influence clinical development, real-world evidence, HEOR, outcomes research, and evidence-generation priorities.

• Work together on payer value propositions, evidence dossiers, payer presentations, budget-impact and cost-effectiveness materials, as well as coding and billing resources and access tools.

• Organize and facilitate payer advisory boards, discussions with medical directors, executive account meetings, and engagements with clinical experts.

• Relay field intelligence, policy trends, competitive access developments, and account risks to cross-functional leadership.

• Collaborate with Medical Affairs, Clinical Affairs, Regulatory, HEOR, Marketing, Sales, Patient Access, Legal, Compliance, and Finance teams.

• Coordinate launch readiness and lifecycle initiatives against established milestones, dependencies, budgets, and performance measures.

• Train internal stakeholders on payer policies, reimbursement pathways, value messaging, and compliant payer engagement.

• May lead employees, consultants, or project teams, including coaching, providing performance guidance, resource planning, and overseeing budgets.

• Complete necessary training and competency confirmations.

• Document product- and therapy-related field reports and provide follow-up information.

• Adhere to quality system, privacy, legal, regulatory, and compliance requirements.

⛳️ Requirements

• Bachelor’s degree in business, health sciences, public health, economics, engineering, or a related field.

• 10 or more years of experience in medical technology, healthcare, payer relations, market access, reimbursement, managed care, or a related field.

• A minimum of 3 years of direct experience in influencing payer coverage, medical policy, reimbursement, contracting, or access strategy.

• Proven knowledge of U.S. commercial insurance, Medicare, Medicaid, medical policy, coding, coverage, and payment pathways for medical technologies.

• Experience in developing strategic account plans and leading complex engagements with health-plan medical directors, policy leaders, or senior payer executives.

• Strong skills in executive communication, presentation, negotiation, consultative processes, analytics, and project management.

• Ability to work independently, exercise sound business judgment, and lead comprehensive cross-functional initiatives within a matrixed environment.

• Willingness to travel up to 75%, including occasional overnight travel.

• Participation in E-Verify is required.

🏝️ Benefits

• Excellent benefits package.

• 401k matching available.

• Employee Stock Purchase Program (ESPP).

• Flexible time off (FTO) policy.

• Tuition reimbursement offered.

• Multiple health insurance plan options accessible.

• Employer contributions to Health Savings Account.

• Comprehensive Dental, Vision, Life, and Disability benefits.

• 401k plan with employer match.

• Identity Protection services.

• Employee Assistance Program available.

• Equity awards provided.

• Opportunity to participate in the ownership and success of Inspire.