Payor Strategy Lead, Regional Accounts

Bausch + Lomb; United States; On-site; USD 140,000 - 185,000; Full time

Job summary

Bausch + Lomb is seeking a Director of Payor Account Management to lead national and regional payor coverage strategies, working with RAMs to optimize Elios System access and reimbursement in the U.S.

You will partner with Field Sales, Medical Affairs, and HEOR teams to secure favorable policies, manage CPT coding, and drive value-based discussions with payors. Travel 25–50% is required.

Qualifications

• Bachelor’s degree in public health, life science, graduate degree preferred.
• 5-7 years of payor relations experience at Medicare and Private Insurance, e.g., national or regional level.
• Strong knowledge of medical device reimbursement and CPT coding.
• Proven track record in securing positive payor coverage and reimbursement with medical devices.
• Strong leadership, communication and collaboration skills.
• Ability to travel 25–50%.

Responsibilities

• Lead the development and execution of national and regional payor coverage and reimbursement strategies to ensure key clinical, HEOR data and overall value propositions result in payor coverage and appropriate reimbursement, commercial viability, and unfettered patient access to the Elios System.
• Engage with health technology assessment firms (HTAs) to provide up-to-date reviews of ELT and Elios System clinical data and support positive conclusions from peer reviewed literature.
• Develop and maintain strong relationships with target payors and understand medical policy, utilization review, PMPM thresholds, health outcomes, risk management, provider contracting, and claims processing.
• Develop relationships with State Ophthalmology Advisory Committee members and payor Medical Directors to support changes reflecting local medical practices.
• Communicate PRC approved payor presentation including literature to demonstrate Elios System’s value to payors.
• Monitor Medicare FFS, Medicare Advantage, and Commercial policies to inform payor strategy and priorities.
• Collaborate with Field Sales Managers to ensure coverage, coding and payment requirements are understood and met.
• Work with Medical Affairs to support Clinical Education with local KOLs to influence payor coverage and medical review policies.
• Improve effectiveness of industry alliances to support policy and patient access.
• Provide VOC feedback to guide strategy development.
• Assist in ensuring MACs provide appropriate coverage and payment for ELIOS.
• Assist in development of market access programs to train Sales Representatives.

Skills

Payor relations

CPT coding

Health economics data

Leadership

Travel flexibility

Cross-functional collaboration

Education

Bachelor’s degree in public health or life sciences

Graduate degree preferred

Ophthalmology experience preferred

Tools

Microsoft PowerPoint

Microsoft Excel

Microsoft Word

Job description

Bausch + Lomb is seeking a Director of Payor Account Management to lead national and regional payor coverage strategies, working with RAMs to optimize Elios System access and reimbursement in the U.S.

You will partner with Field Sales, Medical Affairs, and HEOR teams to secure favorable policies, manage CPT coding, and drive value-based discussions with payors. Travel 25–50% is required.