Main Purpose of the Role

We are seeking a proven and strategic Market Access Manager to spearhead efforts in securing coverage, reimbursement, and pricing for cutting-edge medical devices. This role demands extensive expertise in navigating the intricacies of private insurance carriers, Medicare, and Medicaid, along with a robust ability to drive evidence-based strategies that enhance access and affordability. The ideal candidate will have over 5 years of demonstrated success in market access, pricing, and reimbursement within the medical device industry.

Key Responsibilities:

• Secure favorable medical coverage policies through tailored presentations to payers and health technology assessment committees, emphasizing clinical efficacy, health economics, and patient outcomes.

• Build and maintain relationships with key decision-makers at commercial health plans, Medicaid, Medicare Advantage organizations, Medicaid MCOs, PBMs, and integrated delivery networks via in-person and remote meetings.

• Lead the creation of innovative payer contracts, including value-based reimbursement and outcomes-based arrangements.

• Regularly gather feedback from payer stakeholders to identify barriers to adoption and reimbursement, translating these insights into actionable strategies.

• Collaborate with internal departments such as Field Sales, Inside Sales, Finance, and Marketing to provide insights into healthcare market dynamics, driving marketing, sales, and billing strategies.

• Forge alliances with patient advocacy groups and professional organizations to create a unified voice supporting policies that expand patient access.

• Partner with HEOR and clinical teams to produce white papers, policy briefs, and case studies highlighting the economic and clinical value of products, supporting payer advocacy efforts.

• Work with Commercial and Executive leadership to collaborate with government agencies (e.g., CMS, state Medicaid offices) and advocacy organizations to promote reimbursement pathways for innovative home-use medical devices.

• Conduct in-depth analysis of payer policies, reimbursement trends, and competitive benchmarks to inform strategic decisions.

• Ensure compliance with all regulatory and compliance requirements, including CMS and private payer standards.

Education and Experience (Knowledge, Skills & Abilities)

• A deep strategic and technical understanding of the DME reimbursement environment.

• Strong knowledge of healthcare systems, reimbursement landscapes, and market dynamics.

• Exceptional communication and negotiation skills.

• Analytical mindset with expertise in interpreting health economic and real-world data.

• Ability to work independently in a remote setting while effectively collaborating with a hybrid team.

• Minimum of 5 years of experience in market access, health economics, or reimbursement within the healthcare, pharmaceutical, or digital health sectors.

• Proven success in developing and implementing market access strategies in complex or emerging markets.

• Willingness and ability to travel up to 25–50% of the time, depending on business needs.

• Bachelor’s degree in Life Sciences, Public Health, Health Economics, Business, or a related field, or equivalent experience.

• Self-motivated attitude with the ability to multitask and thrive in a fast-paced environment.

• Organizational competencies to develop and refine processes for consistency and efficiency.

• Project management skills to keep projects on track and communicate to all stakeholders.

• Effective collaboration skills to build partnerships cross-functionally and work with others to meet shared objectives.

• Advanced degree (e.g., MBA, MPH, PhD, RN).

• Experience working in physical medicine and rehabilitation, neurology or orthopedics.

• Experience in a high-performing, entrepreneurial environment.

• Experience in marketing at-home medical devices.

• Experience with senior and executive-level stakeholder engagement.

• Experience working in a medical device or pharmaceutical sales role is a plus.

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