Director, Payer Relations

Inspire Medical Systems Inc.•Minneapolis, MN

1d•$180,000 - $240,000•Remote

About The Position

The Director, Payer Relations develops and executes U.S. payer engagement strategies to secure, expand, and sustain appropriate coding, coverage, payment, and patient access for Inspire Medical Systems’ current and future medical technologies. The role builds strategic relationships with national and regional commercial health plans, Medicare stakeholders, Medicaid programs, Medicare Administrative Contractors, integrated delivery networks, and other payer decision makers. Working across Market Access, Clinical and Medical Affairs, Health Economics and Outcomes Research, Regulatory, Legal, Finance, Marketing, and Sales, the Director translates clinical evidence, economic value, and customer insight into actionable account strategies and favorable access outcomes. The Director owns payer account planning and engagement; monitors coverage, coding, payment, reimbursement, and policy developments; identifies adoption and access barriers; and partners with internal experts to advance appropriate evidence-based coverage and payment. The role also informs evidence-generation priorities, develops payer value communications and access tools, facilitates payer and executive engagements, and coordinates launch-readiness and lifecycle initiatives. The Director trains internal stakeholders on payer policy, reimbursement pathways, value messaging, and compliant engagement practices, and may lead employees, consultants, or project teams. This is a fully remote position with travel of up to 75%, including occasional overnight travel. Success is measured by progress toward favorable payer policies and reduced access barriers, the quality and strategic value of payer relationships, effective account plans and launch milestones, timely communication of payer insights, cross-functional execution, and compliance with company requirements.

Requirements

Bachelor’s degree in business, health sciences, public health, economics, engineering, or a related field.
10 or more years of experience in medical technology, healthcare, payer relations, market access, reimbursement, managed care, or a related field.
At least 3 years of direct experience influencing payer coverage, medical policy, reimbursement, contracting, or access strategy.
Demonstrated knowledge of U.S. commercial insurance, Medicare, Medicaid, medical policy, coding, coverage, and payment pathways for medical technologies.
Experience developing strategic account plans and leading complex engagements with health-plan medical directors, policy leaders, or senior payer executives.
Strong executive communication, presentation, negotiation, consultative, analytical, and project-management skills.
Ability to work independently, exercise sound business judgment, and lead broad cross-functional initiatives in a matrixed environment.
Ability to travel up to 75%, including occasional overnight travel.
Strategic payer engagement and account planning capabilities.
Coverage, coding, and payment expertise.
Evidence-based value communication skills.
Executive presence and influence.
Negotiation and stakeholder-management skills.
Cross-functional leadership capabilities.
Analytical problem-solving skills.
Execution, prioritization, and business judgment.

Nice To Haves

Master’s degree in business administration, public health, health policy, health economics, health services research, or a related discipline.
12 or more years of relevant experience, including medical-device experience and established relationships with national or regional payer decision makers.
Experience supporting one or more product launches and building access pathways for novel procedures, implants, diagnostics, or digital health technologies.
Experience with real-world evidence, HEOR, claims analytics, budget-impact models, value-based care, or payer contracting.
Working knowledge of CMS payment systems, Medicare Administrative Contractors, state Medicaid programs, integrated delivery networks, and health technology assessment processes.

Responsibilities

Develop and execute payer account plans aligned with portfolio, launch, and lifecycle priorities, including objectives, stakeholder maps, engagement sequencing, evidence needs, risks, and measurable outcomes.
Own strategic relationships with assigned national and regional commercial payers, Medicare and Medicaid stakeholders, health-plan medical directors, policy teams, pharmacy or benefit managers where relevant, and payer-affiliated integrated delivery networks.
Lead payer engagements addressing medical policy, utilization-management criteria, coding, reimbursement, payment adequacy, network considerations, and patient-access barriers.
Negotiate and implement appropriate payer agreements or value-based arrangements with Legal, Finance, Compliance, and senior leadership, when applicable.
Monitor and analyze payer policies, coverage criteria, claims experience, reimbursement pathways, policy-review cycles, and emerging federal and state developments affecting access.
Identify barriers to adoption and create action plans to obtain favorable, evidence-based coverage and appropriate payment for eligible patients and providers.
Partner with reimbursement, coding, and health-policy experts on Medicare, commercial, Medicaid, facility, and physician payment strategies.
Support engagement with relevant government, payer, and assessment bodies, including health technology assessment organizations when applicable.
Provide payer insights to shape clinical-development, real-world evidence, health-economics, outcomes-research, and evidence-generation priorities.
Collaborate on payer value propositions, evidence dossiers, payer presentations, budget-impact and cost-effectiveness materials, coding and billing resources, and other access tools.
Organize and facilitate payer advisory boards, medical-director discussions, executive account meetings, and clinical-expert engagements.
Communicate field intelligence, policy trends, competitive access developments, and account risks to cross-functional leadership with clear recommendations.
Partner with Medical Affairs, Clinical Affairs, Regulatory, HEOR, Marketing, Sales, Patient Access, Legal, Compliance, and Finance to execute integrated market-access plans.
Coordinate launch-readiness and lifecycle initiatives against defined milestones, dependencies, budgets, and performance measures.
Train internal stakeholders on payer policy, reimbursement pathways, value messaging, and compliant payer engagement.
May lead employees, consultants, or project teams, including coaching, performance guidance, resource planning, and budget oversight.
Complete required training and competency confirmations within established timelines.
Document product- and therapy-related field reports and provide follow-up information in accordance with applicable procedures and timelines.
Comply with quality-system, privacy, legal, regulatory, and compliance requirements, and recommend opportunities for continuous improvement.
Ensure payer interactions, evidence communications, contracting discussions, and external materials follow approved company processes.