Jobgether

Compensation

Full Description

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 Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching. When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly. 🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements. 📊 It compares your profile to the job’s core requirements and past success factors to determine your match score. 🎯 Based on this analysis, we automatically shortlist the three candidates with the highest match to the role. 🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed. The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role. Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team. Thank you for your interest! 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.