Associate Director of Market access & Payer Strategy

This leader will be responsible for developing and executing a comprehensive payer strategy focused on increasing in-network participation, expanding covered lives, improving reimbursement economics, and driving patient access across Commercial, Medicare Advantage, Medicaid, Managed Medicaid, and Government payer channels.

Key Responsibilities

• Develop and execute a national payer access strategy that increases Liberator's participation within commercial, Medicare Advantage, Managed Medicaid, and government-sponsored health plans.
• Lead negotiations with national and regional health plans to secure favorable reimbursement rates, contract terms, and network participation agreements.
• Renegotiate existing payer contracts to improve reimbursement economics, reduce administrative burdens, and increase long-term profitability.
• Identify new payer contracting opportunities that expand covered lives and improve patient access.
• Develop business cases, financial models, and network expansion strategies supporting contract negotiations.
• Serve as the executive lead during payer negotiations and contracting discussions.
• Establish and execute a Medicare Advantage expansion strategy focused on increasing beneficiary access to PureWick®, Urology, and Ostomy products.
• Lead strategic engagement with Medicare Advantage medical directors and policy committees regarding clinical and economic value propositions.
• Present clinical evidence, health economic analyses, patient outcomes data, and utilization trends supporting expanded coverage decisions.
• Influence payer policy updates that improve access to innovative continence management solutions.
• Develop relationships with key decision-makers at national Medicare Advantage organizations including United Healthcare, AARP-UHC, Humana, WellMed, Blue Cross Blue Shield plans, and other national and regional MA organizations.
• Partner closely with BD's Office of Government Affairs and Office of Market Access to develop reimbursement and public policy strategies.
• Represent Liberator before CMS, state Medicaid agencies, Medicaid managed care organizations, and other relevant healthcare stakeholders.
• Lead initiatives to secure new coverage pathways, billing codes, reimbursement policies, and fee schedule inclusion opportunities where applicable.
• Coordinate the development of clinical dossiers, outcomes research, white papers, economic analyses, and policy submissions.
• Participate in industry coalitions, advocacy groups, and stakeholder forums supporting patient access initiatives.
• Monitor healthcare policy, reimbursement, regulatory, and legislative developments that impact Liberator products and services.
• Recommend proactive strategies to address reimbursement challenges and emerging market opportunities.
• Serve as the market access subject matter expert for PureWick reimbursement and coverage expansion.
• Develop payer-specific coverage strategies for both commercial and government payers.
• Lead initiatives focused on securing broader payer acceptance of PureWick as a covered therapeutic solution.
• Present clinical outcomes and evidence-based support for PureWick coverage to payers, medical directors, and policy committees.
• Collaborate with Clinical Affairs, Medical Affairs, Research, and BD leadership to strengthen reimbursement positioning.
• Partner with Revenue Cycle Management, Operations, Clinical Services, Compliance, Legal, Contracting, Finance, Commercial teams, and Customer Service Leadership.
• Ensure payer contract terms are implemented effectively throughout operational workflows.
• Support payer onboarding, implementation, and operational readiness activities.
• Serve as the escalation point for strategic payer challenges impacting patient access.
• Partner with insurance carriers and internal operational teams to resolve systemic patient access barriers.
• Lead executive-level resolution efforts involving coverage denials, authorization obstacles, contract interpretation disputes, escalated patient complaints, and reimbursement challenges.
• Analyze trends impacting patient experience and develop sustainable corrective actions.
• Advocate for policies and solutions that improve patient access and satisfaction.
• Develop annual market access plans aligned with company growth objectives.
• Analyze market opportunities, covered lives data, reimbursement trends, and competitive landscapes.
• Create executive reporting and market access dashboards.
• Present recommendations and progress updates to BD and LMS executive leadership.
• Evaluate new geographic, payer, and product expansion opportunities.

Required Qualifications

• Bachelor's Degree in Business, Healthcare Administration, Public Health, Finance, Political Science, Health Policy, or related field.
• 10+ years of healthcare market access, managed care contracting, payer relations, reimbursement, government affairs, provider contracting, or healthcare policy experience.
• Demonstrated success negotiating contracts with national and regional health plans.
• Deep understanding of Medicare, Medicare Advantage, Medicaid, Managed Medicaid, Commercial Insurance, and Healthcare reimbursement systems.
• Experience engaging medical directors, payer policy leaders, and government agencies.
• Strong financial, contracting, and reimbursement modeling capabilities.
• Excellent executive communication and presentation skills.
• Ability to influence senior leaders both internally and externally.
• Proven ability to operate independently in highly complex environments.

Preferred Qualifications

• MBA, MHA, MPH, JD, or related advanced degree.
• Experience in DMEPOS, Home Medical Equipment, Medical Devices, Urology, Ostomy, Continence Care, or Healthcare Distribution.
• Experience working with CMS, Medicaid agencies, and healthcare policymakers.
• Existing relationships with payer organizations and healthcare policy stakeholders.
• Experience navigating coverage determination, coding, reimbursement, and fee schedule development processes.
• Experience collaborating with government affairs and industry advocacy organizations.
• Knowledge of value-based care and health economics research.