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Director of Market Access/Payer Engagement
PRIA Healthcare
Posted on Mar 1, 2025
PRIA Healthcare is seeking a highly motivated and experienced professional to join our team as the Director of Market Access. Reporting to the Vice President of Business Development & Marketing, this individual will play a critical role in expanding PRIA’s payer and stakeholder engagement business segment.
The ideal candidate will have deep expertise in the U.S. healthcare ecosystem and reimbursement landscape for medical devices, with a proven ability to develop and execute successful market access strategies. Specifically, this role requires strong relationship management skills, a collaborative spirit and strategic mindset, with a track record of executing creative solutions and forging synergistic partnerships between key stakeholders, including: payers, providers, facilities, specialty socieities, to achieve common objectives. The Director of Market Access will serve as a primary point of contact for clients, collaborating cross-functionally to deliver exceptional service and drive market adoption.
Key Responsibilities
· Lead and support specific payer engagement initiatives, leveraging existing relationships to influence policy development and reimbursement strategies across national and regional commercial payers, integrated develivery networks, independent physician associations, and Government payers.
· Develop and execute market access strategies to ensure favorable reimbursement and coverage for clients' medical technologies.
· Collaborate with PRIA’s Market Access team to develop and communicate strategic plans, tactics, and payer engagement initiatives.
· Establish and strengthen relationships with key opinion leaders (KOLs) and influential stakeholders within payer organizations and the MedTech community.
· Work cross-functionally with PRIA’s Reimbursement, Health Economics, and Market Access teams to ensure comprehensive strategy execution.
· Analyze and present data-driven insights, identifying trends and ensuring programs align with client goals.
· Manage administrative tasks associated with overseeing a portfolio of clients.
Qualifications
· Bachelor’s degree required; advanced degree preferred.
· 10+ years of experience in U.S. reimbursement and market access, preferably in a consulting, HUB services, or MedTech environment.
· Strong expertise in coding constructs (HCPCS, CPT, ICD-10) and their relation to coverage policies, utilization management guidelines, and claims adjudication.
· Deep understanding of federal and state regulations related to medical reimbursement, including payment models for outpatient, inpatient, DME, and physician office settings.
· Experience collaborating with internal teams (e.g., billing, coding, patient access programs) to resolve coding and coverage challenges.
· Excellent communication and interpersonal skills, with the ability to confidently guide clients, articulate value propositions and clinical data to influence payer decision-making.
· Demonstrated success in securing payer policies and contract terms that establish medical technology as medically necessary.
· Strong analytical skills to interpret data, identify trends, and develop actionable insights.
· Results-driven mindset, committed to exceeding client expectations and delivering measurable outcomes.
· Problem-solving ability, with a proactive approach to identifying client challenges and recommending solutions.
· Payer contracting experience preferred