Director, Payer - Policy Analysis & Reimbursement Strategy

Remote Full-time
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Director, Payer - Policy Analysis & Reimbursement Strategy in Florida (USA). The Director, Payer is responsible for leading the strategic development and execution of payer policy analytics to optimize access and reimbursement strategies. This role oversees the creation and management of proprietary payer knowledge, monitors changes in coverage and reimbursement trends, and translates insights into actionable strategies across programs. The ideal candidate is highly analytical, data-driven, and skilled in cross-functional collaboration, with deep expertise in U.S. payer dynamics, both medical and pharmacy benefits. The role involves mentoring a team of analysts, driving the development of dashboards and reporting tools, and collaborating with internal and client stakeholders to ensure differentiated, high-impact access solutions. This position offers the opportunity to shape strategic market access initiatives while leveraging technology and data to drive measurable results. • Accountabilities: • Establish and lead a payer-focused committee to develop, maintain, and share payer insights across all programs. • Analyze and interpret payer policies across commercial, Medicare, and Medicaid plans, including case reviews and integration into proprietary systems. • Develop and maintain a payer intelligence framework to track coverage criteria, prior authorization requirements, and reimbursement trends. • Partner with internal teams (Market Access, Reimbursement, Analytics, Clinical, Regulatory) to translate payer insights into actionable strategies. • Serve as product owner for proprietary payer management platforms, defining roadmap, enhancements, and digital solutions. • Collaborate with sales and business development teams to support RFPs, presentations, and client engagement. • Design and implement dashboards and reporting tools to measure payer policy impact and access metrics at program and enterprise levels. • Represent the organization in client meetings and quarterly business reviews, providing strategic guidance on payer policy and market access. • Mentor and provide indirect leadership to payer analysts and reimbursement specialists, supporting professional development and performance feedback. • Requirements: • Bachelor’s degree in health policy, public health, pharmacy, or related field; advanced degree (MPH, MBA) preferred. • 7–10 years of experience in payer policy analysis, market access, or reimbursement strategy within the pharmaceutical or healthcare industry. • Deep understanding of the U.S. payer landscape, including commercial, Medicare, and Medicaid coverage pathways. • Experience with both medical and pharmacy benefit structures and policy development. • Strong analytical skills with proficiency in data visualization and reporting tools (e.g., Excel, Tableau, Power BI). • Experience as a technology product owner, including defining vision, requirements, and participating in agile development cycles. • Excellent written and verbal communication skills, capable of translating complex data into actionable insights. • Demonstrated ability to lead cross-functional teams and manage multiple priorities in a fast-paced environment. • Benefits: • Competitive salary • Career growth and promotion opportunities • 401K with company match • Tuition reimbursement • Flexible work environment and remote options • Discretionary PTO and paid holidays • Medical, dental, and vision coverage • HSA/FSA and telemedicine access • Wellness programs and employee assistance programs • Adoption assistance • Short-term and long-term disability coverage • Life insurance • Employee discount programs Why Apply Through Jobgether? 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! 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. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us. Apply tot his job
Apply Now →

Similar Jobs

Senior Research Analyst, Social Determinants of Health, Bureau of Chronic Disease Prevention

Remote

Grievance/Appeals Analyst I

Remote

Social Science Research Analyst

Remote

Project Manager - Healthcare - Remote - Remote

Remote

Payment Integrity Analyst III

Remote

healthcare Program Manager or healthcare Project Manager(Remote)

Remote

Project Manager, Value Based Care

Remote

Transform Healthcare Projects as a Senior Project Manager (Remote)

Remote

GE Healthcare Project Manager – Patient Care Solutions (Remote – Greater Illinois Area) in Remote, Illinois

Remote

Healthcare Project Manager

Remote

Seasonal Ad Operations Coordinator [Remote]

Remote

YouTube Moderator: Join the Team Behind the World’s Largest Video Sharing Platform

Remote

Experienced Remote Data Entry and Administrative Assistant – Flexible Work from Home Opportunity with blithequark

Remote

Client Services Associate / Travel at HB Travels Bismarck, ND

Remote

Freelance Writer/Copywriter (Remote, Contract) – Amazon Store

Remote

Experienced Live Chat and Email Support Specialist for Dynamic Customer Service Team – Fully Remote Opportunity with Comprehensive Training and Flexible Scheduling

Remote

Wayfair Job Openings Remote, Wayfair Application Status, Wayfair Jobs Click To Apply!!

Remote

Experienced Virtual Receptionist and Data Entry Clerk - Administrative Support with blithequark

Remote

Experienced Customer Experience Advisor - Email, Chat, Call Support Specialist at blithequark

Remote

**Experienced Phone and Chat Specialist with Bonus Opportunities – Join blithequark's Critical Team Supporting Essential Healthcare Workers**

Remote
← Back