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Koya Medical, Inc.

National Account Director – Market Access & Payer Strategy

Posted 2 hours ago
$175K - $185K per year
5-10 years experience
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AI Summary

The National Account Director will lead proactive payer engagement efforts to expand medical policy coverage and improve reimbursement access across a national portfolio. They will build strategic relationships with payer medical directors and contracting executives to drive commercial growth and resolve access barriers.

Position Summary

This is a strategic, field-facing market development role operating at the intersection of payer strategy, commercial execution, and healthcare market access.


The National Account Director – Market Access & Payer Strategy will lead proactive payer engagement efforts across an assigned national portfolio of regional and local health plans, focused on expanding medical policy coverage, improving reimbursement access, establishing in-network pathways, and advancing payer relationships across commercial health plans and Medicaid managed care organizations.


This is not a traditional reimbursement support, prior authorization, claims management, or payer operations role.


This role is designed for a commercially oriented hunter with a demonstrated track record of driving payer access outcomes through strategic relationship development, medical policy engagement, and payer contracting discussions.


The ideal candidate has successfully operated in ambiguous or evolving reimbursement environments where payer pathways may not yet be fully established, and success requires persistence, executive influence, strategic thinking, and independent execution.


Key Responsibilities

Strategic Payer Market Development

· Proactively identify, segment, prioritize, and develop payer access opportunities across an assigned national portfolio of commercial and Medicaid managed care organizations, focusing resources on accounts with the greatest access, commercial, and strategic opportunity

· Independently build and expand relationships with payer medical directors, contracting executives, network leadership, utilization management teams, and policy stakeholders

· Develop and execute payer engagement strategies from initial outreach through coverage, contracting, and implementation

· Identify opportunities across the national account portfolio to improve payer access, commercial scalability, and provider adoption


Medical Policy & Coverage Expansion

· Engage payer clinical leadership to influence favorable medical policy and reimbursement positioning decisions

· Present compelling clinical evidence, health economic data, patient outcomes, and market differentiation in a persuasive and commercially credible manner

· Leverage KOLs, advocacy partnerships, provider relationships, and market intelligence to support payer engagement strategies

· Identify and proactively address utilization management, prior authorization, medical policy, and network barriers limiting commercial growth

· Monitor competitive access dynamics, payer policy changes, operational friction, and reimbursement trends to inform national account strategy and portfolio prioritization


Contracting & Access Strategy

· Lead strategic discussions related to payer contracting, in-network access, reimbursement pathways, and commercial access expansion

· Partner with senior leadership on pricing strategy, contract positioning, and implementation planning

· Drive payer opportunities through extended and complex negotiation cycles

· Support resolution of high-impact payer barriers affecting commercial execution and growth objectives across the assigned national account portfolio


Commercial & Cross-Functional Collaboration

· Partner closely with sales leadership, reimbursement operations, clinical teams, marketing, and executive leadership

· Translate payer access dynamics into actionable commercial strategy, provider targeting, and field deployment recommendations

· Serve as a national payer intelligence resource for commercial teams and Regional Market Access Directors


Required Qualifications

· Bachelor’s degree in healthcare, life sciences, business, or related field

· 5+ years of successful experience in one or more of the following:

· Medical device commercial sales

· Strategic healthcare account management

· Payer market access

· Managed care contracting

· Healthcare business development


Required Experience

· Demonstrated success influencing commercial payer access outcomes, including favorable medical policy, reimbursement pathways, in-network access, and payer contracting

· Proven ability to independently develop and manage relationships with payer medical directors, commercial contracting executives, network leadership, and utilization management stakeholders

· Track record of proactively opening strategic payer opportunities and advancing complex payer discussions through extended sales and negotiation cycles

· Strong commercial orientation with demonstrated success in growth-focused, accountable commercial environments

· Demonstrated ability to operate independently with high levels of ownership, strong sense of urgency, action biased, persistence, and accountability

· Strong executive communication, negotiation, and relationship management skills

· Ability to communicate clinical and economic value propositions credibly in high-stakes payer discussions


Candidates without direct commercial payer engagement and demonstrated payer access success experience will not be competitive for this role.


Strongly Preferred

· Medical device or healthcare commercial sales background with direct payer-facing responsibilities

· Experience selling into reimbursement-dependent healthcare markets

· Existing commercial payer relationships across regional and local health plans

· Experience operating within emerging or evolving reimbursement categories

· Growth-stage or startup healthcare experience

· Experience within vascular, venous, lymphedema, wound care, cardiology, oncology, DME, or specialty provider markets


Core Competencies

· Hunter mentality with strong commercial instincts

· Executive presence and strategic negotiation skills

· Independent ownership mindset

· Resilience, persistence, and adaptability

· Comfort operating in ambiguity and evolving market conditions


Travel: Up to 30%


Compensation: Competitive base salary + performance bonus + equity opportunity + full benefits

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