Director, Payer Relations

The role

The Director, Payer Relations develops and executes U.S. payer engagement strategies to secure coding, coverage, payment, and patient access. This role builds strategic relationships with commercial health plans, Medicare, Medicaid, and other payer decision makers.

What you will do

• Develop and execute payer account plans aligned with portfolio and lifecycle priorities.
• Own strategic relationships with national and regional commercial payers and Medicare/Medicaid stakeholders.
• Lead payer engagements addressing medical policy, utilization-management, coding, and reimbursement.
• Negotiate and implement payer agreements or value-based arrangements.
• Monitor and analyze payer policies, coverage criteria, and reimbursement pathways.
• Identify barriers to adoption and create action plans for favorable coverage.
• Partner with reimbursement, coding, and health-policy experts.
• Provide payer insights to shape clinical-development and evidence-generation priorities.
• Collaborate on payer value propositions and evidence dossiers.
• Organize payer advisory boards and executive account meetings.

Required qualifications

• 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.
• At least 3 years of direct experience influencing payer coverage, medical policy, reimbursement, contracting, or access strategy.
• Demonstrated knowledge of U.S. commercial insurance, Medicare, Medicaid, medical policy, coding, coverage, and payment pathways for medical technologies.
• Experience developing strategic account plans and leading complex engagements with health-plan medical directors, policy leaders, or senior payer executives.
• Strong executive communication, presentation, negotiation, consultative, analytical, and project-management skills.
• Ability to work independently and lead broad cross-functional initiatives in a matrixed environment.
• Ability to travel up to 75%, including occasional overnight travel.

Nice to have

• Master’s degree in business administration, public health, health policy, health economics, health services research, or a related discipline.
• 12 or more years of relevant experience, including medical-device experience and established relationships with national or regional payer decision makers.
• Experience supporting one or more product launches and building access pathways for novel procedures, implants, diagnostics, or digital health technologies.
• Experience with real-world evidence, HEOR, claims analytics, budget-impact models, value-based care, or payer contracting.
• Working knowledge of CMS payment systems, Medicare Administrative Contractors, state Medicaid programs, integrated delivery networks, and health technology assessment processes.

Benefits

• Multiple health insurance plan options.
• Employer contributions to Health Savings Account.
• Dental, Vision, Life and Disability benefits.
• 401k plan + employer match.
• Identity Protection.
• Flexible time off.
• Tuition Reimbursement.
• Employee Assistance program.
• Equity awards.
• Employee Stock Purchase Program.

About the company

Inspire Medical Systems is a medical device company focused on Obstructive Sleep Apnea (OSA). The company is committed to enhancing patients' lives through sleep innovation.