Director, Payor Relations

The Director of Payor Relations will be responsible for ongoing strategic innovation, cross-functional collaboration and the development and execution of new coverage, pricing and market access strategies. This role will create and deliver Managed Market and Market Access strategies that differentiate and demonstrate a patient-centered approach, while leading and managing
reimbursement. This role reports directly to the Chief Commercial Officer.

The overall compensation range for this role is market driven, with a salary range of $165,000 - $200,000 and OTE of $215,000-$250,000. This market range is based on our base compensation. Additionally, we offer Cala Health company stock options and a robust benefits package. This offering is aligned with our overall compensation philosophy.

Desired Skills and Experience

New Payor Coverage

• Develop strong relationships with target payor organizations that help Cala Health gain new
  coverage to achieve revenue targets.
• Gain favorable policy decisions for Cala Heath's products by delivering clinical, health economic and scientific information to key decision makers within targeted government and commercial health plans.
• Work cross functionally within Cala Health to develop materials which will assist in gaining new policy coverage or overturning negative coverage decisions.
• Partner with key advocacy groups, Key Opinion Leaders and physician champions to gain their assistance to deliver critical information to government and commercial payers
• Maintain awareness of key trends in the neuromodulation space which may affect Cala Health.

Payer Contracting

• Determine important payor contacts at various levels within the health plan and engage with Cala employees to establish relationships with peer counterparts.
• Develop and manage relationships with executives at multiple payers, locally and nationally.
• Successfully negotiate favorable contracts with various payers using a diverse range of techniques and contracting best practices.
• Manage contractual relationships and ensure accurate administration of contract terms including informing the various contracted payers about newly credentialed providers.

Strategy and Pricing

• Execute payer strategies with overall company direction and commercial goals
• Work collaboratively with Sales and Marketing to connect payor, provider and patient marketing strategies.
• Work with Senior Director of Market Access to analyze, evaluate and execute regional and national payer approaches. Prioritize payor targets to maximize value for Cala Health.
• Proactively identify and recommend new growth opportunities (primarily within the payer community), creating the required business case and gaining approval.
• Lead key meetings with payers on how to maximize the value proposition.
• Act, along with the Chief Commercial Officer, as one of the primary liaisons between Cala Health and payors, strengthening our overall relationship and creating a mutual loyalty.
• Ensure that all payer relationships are managed in accordance with Cala Health standards.
• Support regional sales management to quickly impact new high potential accounts and assure that billing and reimbursement issues are appropriately managed at the outset and Operations payer : contracts are in place.
• Liaison with marketing to create best in class support materials for Territory Managers, payor advocates and customer success
• Provide market knowledge to assist in the development of physician advocacy, gather key data resources and/or acquire analytical tools necessary to better evaluate the effectiveness of customer messaging.
• Partner with Sales on value proposition discussions and develop messaging and tools that drive new coverage and reimbursement growth and achieve overall financial goals.
• Identify and recommend appropriate operational changes to achieve maximum efficiency with payors.