Job Summary

The Regional Account Manager is responsible for securing and expanding payer access

for products by engaging directly with commercial health plans and Medicaid

Managed Care Organizations across the assigned region. This role focuses on

achieving favorable medical policy, in-network status, and reduced access barriers to

ensure patients and providers can fully benefit from technology.

The position plays a critical role in building and sustaining strong, strategic relationships

with key regional payers. Success requires frequent engagement with senior medical

directors, contracting leaders, and other health plan decision makers, as well as close

collaboration with the leadership team. Exceptional communication, strategic

thinking, and presentation skills are essential.

This position will report to the Senior Director, Market Access. The role is full-time and remote, Western US.

Essential Job Functions: Regional Account Manager;

● Develop and execute payer access strategies for assigned regional health and Managed Medicaid plans.

● Engage key medical policy stakeholders to drive adoption and coverage of products

● Engage key payer contracting stakeholders to negotiate and establish in-network contracts for products

● Identify and resolve coverage and prior authorization barriers to product adoption and utilization

● Serve as the primary point of contact for payer decision makers (medical directors, contracting, network management, policy teams)

● Develop strong relationships with targeted payers and build a working knowledge of their key processes including medical policy, utilization review, provider contracting, quality management, and claims processing.

● Partner with Payer Relations/Payer Operations teammates for the development and execution of payer coverage, reimbursement, pricing, and contracting strategies in order to ensure commercial viability and improve patient access to novel therapies.

● Design and implement strategies that leverage KOL’s, patient advocacy groups, state regulations and clinical and economic data to secure favorable medical policy and coverage decisions from payer

● Monitor competitors’ strategies and market dynamics to identify opportunities and threats in payer contracting and medical policy. Use insights to inform strategy and stay ahead in the market.

Minimum Qualifications

Education, Experience and Training:

• Bachelor’s degree in Life Science, Healthcare, Business or related field.
• Minimum of 5 years of experience in market access, payer contracting, reimbursement strategy, or related roles within the medical device/diagnostics/pharmaceutical industry.
• Demonstrated success securing positive medical policies, and driving in-network contracting with regional payers.
• Deep understanding of medical policy development, credentialing, contracting, and reimbursement processes across commercial, Medicare and Medicaid programs.
• Proven ability to manage multiple payer accounts and projects simultaneously with a focus on achieving measurable results.
• Strong clinical acumen with the ability to effectively communicate clinical and economic value to medical directors and other key payer stakeholders
• Excellent negotiation, communication, presentation, and relationship-building skills.
• Strong analytical skills with the ability to analyze payer trends, competitive dynamics, and market access opportunities to inform strategy.
• Strategic mindset with the ability to work independently and drive results.
• Strategic, self-motivated, and results-driven, with strong problem-solving abilities and attention to detail.
• Ability to adapt to the fast-changing healthcare and reimbursement environment.
• Must be able to travel at least 30% of the time

Tools and Technology

[G Suite, Microsoft Office Suite, Adobe, Salesforce CRM, etc.]

Physical Functions:

The physical functions described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers; handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate

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