Director, Commercial Reimbursement

Job Description

• This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Director, Commercial Reimbursement in the United States. This is a high-impact leadership opportunity for an experienced reimbursement and market access professional passionate about improving patient access within the healthcare and medical device industry. The role focuses on leading commercial payer reimbursement strategy, payer engagement, and reimbursement operations across a growing and innovative healthcare organization. You will work closely with cross-functional leaders in commercial, medical, sales, finance, and compliance teams to shape reimbursement pathways, influence payer policies, and resolve complex coverage challenges. This position combines strategic leadership with hands-on problem solving, requiring expertise in commercial payer negotiations, provider engagement, and reimbursement operations. The ideal candidate thrives in a fast-paced, collaborative environment and brings a strong understanding of healthcare policy, reimbursement frameworks, and market access strategy. This remote role also offers the opportunity to lead and develop a high-performing team while driving initiatives that directly impact patient access and business growth.
• Accountabilities: Lead the development and execution of commercial reimbursement strategies aligned with organizational growth objectives and market access priorities. Manage relationships with national, regional, and local commercial health plans, including direct engagement with medical directors and payer leadership teams. Drive commercial payer coverage initiatives by influencing reimbursement policies, challenging restrictive coverage determinations, and supporting appropriate access pathways. Lead escalation efforts for complex payer disputes, reimbursement barriers, policy appeals, underpayment issues, and high-risk coverage challenges. Serve as the primary reimbursement expert for payer negotiations, peer-to-peer discussions, reconsideration requests, and provider support initiatives. Partner with physicians and healthcare providers to support reimbursement advocacy efforts, operational alignment, and site-of-care reimbursement strategies. Oversee reimbursement operations and provide leadership, coaching, and development support to the Market Access Manager team. Establish standardized processes, tools, and best practices to ensure operational consistency and high-quality reimbursement execution across the organization. Collaborate cross-functionally with commercial, sales, finance, legal, medical affairs, and compliance teams to support launch readiness, field enablement, and reimbursement planning. Develop reimbursement performance metrics, reporting dashboards, and analytical insights to identify risks, opportunities, and strategic priorities. Utilize payer policy intelligence and claims data to support reimbursement analysis, denial trend monitoring, and strategic decision-making initiatives. Represent reimbursement and market access perspectives in leadership discussions and strategic planning forums. Requirements: Bachelor’s degree required; advanced degree in health policy, public health, health services administration, or related field preferred. Minimum of 8 years of progressive experience in reimbursement, market access, payer relations, or healthcare strategy within medical devices or healthcare organizations. Proven expertise working with commercial health plans, payer negotiations, policy reviews, and coverage advocacy initiatives. Strong understanding of prior authorization processes, claims management, appeals, reimbursement operations, and outpatient reimbursement pathways. Experience working with commercial payer intelligence platforms, claims datasets, and reimbursement analytics tools. Familiarity with coding, reimbursement methodologies, and site-of-service considerations across healthcare settings. Demonstrated experience partnering with physicians and providers on payer discussions, appeals, and reimbursement strategies. Prior people management experience with accountability for team performance, coaching, and employee development. Strong organizational and project management skills with the ability to manage multiple priorities and cross-functional initiatives. Excellent communication, presentation, and stakeholder management skills in both virtual and in-person settings. Proficiency with Microsoft Office applications including Excel, PowerPoint, Word, and Outlook. Ability and willingness to travel up to 40% as needed. Eligibility to work legally in the United States is required. Benefits: Competitive base salary ranging from $210,000 to $225,000 annually based on experience and qualifications. Performance-based variable incentive compensation opportunities. Stock options and long-term ownership opportunities within a mission-driven healthcare company. Comprehensive healthcare insurance coverage. 401(k) retirement savings plan. Paid vacation and time-off benefits. Fully remote work flexibility within the United States. Opportunity to work with experienced industry leaders in a collaborative and innovative environment. Ongoing professional development, learning opportunities, and exposure to dynamic healthcare market access challenges. Inclusive workplace culture committed to diversity, equity, and employee growth. Opportunity to contribute to meaningful healthcare innovation that improves patient outcomes and access to care.
• 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
• 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.
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