Payer Relations Director

Payer Relations Director - West

Location: Remote (West Region)

Role Overview:
The Payer Relations Director - West is responsible for managing coverage, coding, and reimbursement processes across Pharmacy Benefit Managers, National & Regional Health Plans, Medicare Advantage, and Medicaid. This role focuses on securing and maintaining payer coverage, removing reimbursement barriers, and supporting sales for Glaukos marketed products. The PRD will collaborate with internal teams and key healthcare stakeholders to drive favorable coding, coverage, and payment for current and future technologies.

Key Responsibilities:

• Develop and execute strategies to secure and maintain coverage for new and existing products with PBMs, commercial payers, Medicare Advantage, and Medicaid
• Partner with Sales, Reimbursement Liaison, and leadership teams to support KOL healthcare providers with reimbursement needs
• Build sustainable relationships with payers, advocacy groups, and healthcare stakeholders
• Analyze and interpret healthcare regulations and legislation
• Travel required: 50%+ (3-4 nights/week)

Qualifications:

• 15+ years of relevant industry experience
• 10+ years in payer medical devices and procedural pharmaceuticals; direct biologic launch and ophthalmology experience preferred
• In-depth knowledge of buy and bill systems, reimbursement processes, and coding (T codes, J codes, appeals)
• Experience with PBMs, health plans, Medicare Advantage, Medicaid, and account management
• Minimum 2 years in practice management, billing, revenue cycle, or reimbursement in pharma/managed care
• Bachelor's degree required; advanced degree or practice management experience preferred
• Strong communication, project management, and teamwork