Director, Commercial Reimbursement

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director, Commercial Reimbursement based in United States.

This is a senior market access leadership role focused on shaping commercial reimbursement strategy and expanding patient access to innovative medical technology. You will lead payer coverage strategy, reimbursement operations, negotiations, and high-impact coverage escalations across national, regional, and local health plans. The role combines strategic payer engagement with hands-on oversight of complex reimbursement challenges, including policy disputes, denials, appeals, and underpayment issues. You will manage and develop a team of Market Access Managers while serving as a trusted subject-matter expert across the organization. Strong collaboration with Commercial, Sales, Medical Affairs, Legal, Compliance, and Finance teams will be essential. This is an opportunity to influence reimbursement strategy, strengthen operational execution, and help remove barriers to appropriate patient access in a fast-moving healthcare environment.

Accountabilities: Develop and execute commercial reimbursement strategies aligned with business objectives, growth priorities, and market access needs.

Lead engagement with national, regional, and local commercial health plans, including medical directors and payer policy teams, to support appropriate coverage and reimbursement.

Drive initiatives to influence or revise payer medical policies, address non-coverage determinations, challenge restrictive utilization criteria, and establish appropriate coverage pathways.

Lead escalations involving complex payer policy disputes, coverage barriers, reimbursement challenges, underpayments, and other issues with significant access or revenue implications.

Serve as the primary commercial reimbursement contact for payer negotiations and senior-level escalations, including peer-to-peer discussions, appeals, reconsiderations, and direct engagement with payer leadership.

Partner with physicians and providers to develop payer engagement strategies, strengthen appeal efforts, and address reimbursement challenges across outpatient sites of service.

Manage and develop the Market Access Manager team by setting priorities, establishing performance expectations, coaching team members, and strengthening functional capabilities.

Build standardized reimbursement processes, tools, and best practices that improve field execution, consistency, and operational efficiency.

Collaborate with Commercial, Sales, Medical Affairs, Legal, Compliance, and Finance to integrate reimbursement considerations into commercial planning, launch readiness, and field enablement.

Develop reimbursement performance metrics and reporting, using payer policy intelligence and claims data to identify risks, trends, opportunities, and priorities for senior-level intervention.

Continuously improve reimbursement strategy and operational effectiveness through data-driven insights and evolving payer, coding, payment, and healthcare market dynamics.

Requirements

Bachelor’s degree required; an advanced degree in health policy, health services administration, public health, or a related discipline is preferred.

8+ years of progressively responsible experience in reimbursement, market access, payer relations, or a related function within medical devices or healthcare, including experience at a Senior Manager or Director level.

Demonstrated experience working with commercial health plans, including payer policy review, coverage advocacy, negotiations, and escalations.

Strong knowledge of commercial prior authorization, claims processing, appeals, reimbursement processes, coding, payment, and outpatient site-of-service considerations.

Experience using commercial payer data sources and claims datasets to analyze coverage, denial trends, reimbursement performance, and payer decision-making.

Experience evaluating and addressing complex reimbursement challenges and developing practical, risk-based strategies.

Proven experience partnering with physicians and providers on payer discussions, reimbursement challenges, or appeal strategies.

Previous people management experience with accountability for team performance, coaching, and professional development.

Strong cross-functional collaboration skills, with the ability to manage multiple priorities and influence stakeholders across different functions.

Excellent analytical, organizational, written, verbal, and presentation skills, with strong attention to detail and sound business judgment.

Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint.

Willingness to maintain required hospital credentialing, vaccinations, and immunizations.

Ability to travel up to 40% and work remotely while maintaining effective relationships across internal and external stakeholders.

Must be legally authorized to work in the United States.

Benefits

Competitive base salary of $210,000–$225,000 , plus a variable incentive plan.

Stock options providing an opportunity to participate in the organization’s growth.

Comprehensive employee benefits, including healthcare insurance.

401(k) plan.

Paid vacation.

Opportunity to work with experienced healthcare and market access professionals in a collaborative, high-achieving environment.

Exposure to dynamic challenges and opportunities for continuous professional growth.

Inclusive workplace focused on diversity, collaboration, and meaningful impact.

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