Market Access & Payer Manager
$94,000–$122,000 year
RemoteUnited States
Job Summary
Establish and maintain relationships with regional and national commercial payers, government programs, and managed care organizations. Support contract negotiations, reimbursement rate discussions, and payer credentialing processes while monitoring policy changes and prior authorization trends. Collaborate cross-functionally with Market Access, Government Affairs, Clinical, and Sales teams to develop value propositions and streamline reimbursement pathways. Resolve coverage and reimbursement issues with Revenue Cycle teams and provide analytical support for payer performance metrics. Track Medicare and Medicaid policy impacts and assist in developing educational materials for stakeholders. Requires 5+ years of market access experience, 30-40% travel, and a Bachelor's degree.
Required Qualifications
- Bachelor's degree in business, healthcare administration, life sciences, or a related field
- 5+ years of direct experience in market access, payer relations, health policy, reimbursement, or a related field in the healthcare, medical device, or pharmaceutical industry
- Strong understanding of commercial and government payer systems, reimbursement policies, and managed care dynamics
- Experience with CPT, ICD-10, and HCPCS coding, as well as payer credentialing and contracting processes
- Familiarity with prior authorization processes and payer utilization management requirements
- Proficiency in working cross-functionally within a matrixed organization
- Must be able to travel up to 30-40% for payer meetings, conferences, and internal stakeholder engagements
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