Jobgether
Accountabilities:: Own, manage, and continuously improve the reimbursement support program, including prior authorization assistance, appeals strategies, benefit investigations, and escalation pathways. Establish and monitor program KPIs such as approval rates, turnaround times, denial overturn rates, and other measures of access performance, reporting results to commercial leadership. Manage vendors and hub-service partners supporting reimbursement operations and ensure field teams and provider offices receive appropriate training and support. Serve as the escalation point for complex access cases, reimbursement challenges, and emerging payer barriers. Develop and execute national and regional payer strategies to establish, maintain, and expand coverage for spinal cord stimulation and closed-loop therapy. Monitor and influence coding, coverage, and payment dynamics across CPT/HCPCS, DRG/APC, physician fee schedules, commercial insurance, Medicare, and Medicaid. Track CMS policy developments and assess the potential impact of emerging payment and value-based initiatives on chronic pain and neuromodulation. Lead the development of value-based and shared-risk contracting frameworks that leverage objective therapy-generated data as a differentiator. Translate clinical and real-world evidence into payer-facing value dossiers, objection-handling materials, coverage advocacy resources, and other evidence-based communications. Support medical policy engagement, including responses to draft policies, technology assessments, and payer advisory interactions. Build relationships with relevant medical societies and professional organizations to advance coverage advocacy, coding initiatives, and clinical guideline development. Equip Sales and field reimbursement teams with the tools, training, and messaging needed to navigate payer and access discussions effectively. Collaborate with Marketing, Sales, and Therapy Awareness teams to integrate market access considerations into commercial campaigns and launch strategies. Build and mentor market access capabilities as the function grows, including management of direct reports and contracted field reimbursement resources as assigned. Represent the organization with professional societies, industry coalitions, and other external groups on reimbursement, policy, and market access matters. Requirements: Bachelor’s degree required; an advanced degree such as an MBA, MPH, MHA, JD, or equivalent is preferred. 10+ years of progressive experience in medical device market access, reimbursement, payer strategy, or a closely related field. Strong experience in neuromodulation, spine, interventional pain, or related medical device markets is highly preferred. Demonstrated success managing reimbursement support or hub-services programs, including vendor management, operational oversight, and KPI performance. Deep knowledge of U.S. coding, coverage, and payment systems across hospital outpatient, ambulatory surgery center, and physician office settings. Proven experience engaging directly with payers on medical policy, coverage expansion, reimbursement strategy, and contracting. Working knowledge of CMS payment models and emerging value-based care trends. Experience translating clinical and real-world evidence into compelling payer and executive-facing value narratives. Strong cross-functional leadership, stakeholder management, and executive communication skills. Experience launching or supporting coverage for novel Class III medical devices or breakthrough technologies is preferred. Experience developing value-based or risk-sharing agreements using objective data generated by medical devices is preferred. Established relationships with payers, specialty societies, professional organizations, or other stakeholders within the pain management and neuromodulation space are preferred. Strategic and hands-on approach, with the ability to move between developing market access strategy and resolving individual reimbursement challenges. Strong analytical and storytelling capabilities, with the ability to turn clinical evidence, reimbursement data, and program metrics into clear recommendations. Collaborative leadership style and ability to build trust across Sales, Clinical, Finance, Marketing, and other functions. Ability to operate effectively in a growth-stage environment, take initiative, navigate ambiguity, and develop new processes and strategies as the function evolves. Benefits: Fully remote position within the United States. Full-time employment opportunity. High-visibility leadership role with direct influence over U.S. market access and reimbursement strategy. Opportunity to shape patient access to innovative medical device therapies. Significant cross-functional exposure across commercial, clinical, regulatory, marketing, and finance functions. Opportunity to build and develop the market access and reimbursement function as the organization scales. Ability to engage with payers, providers, professional societies, industry groups, and policy stakeholders. Inclusive and collaborative environment that values integrity, innovation, performance, and patient impact. Opportunity to contribute to the development of value-based contracting and evidence-driven reimbursement strategies. Professional growth through leadership of complex market access initiatives and external stakeholder relationships. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1