The Director, Payer Relations and Value-Based Offerings is a senior-level executive reporting into the Vice President, Health Economics and Market Access (HEMA) and functioning in a strategic, highly visible leadership position. This leader is responsible for developing Boston Scientific’s senior level strategic relationships with key United States (U.S.) health plans, including national plans and integrated delivery network (IDN)-owned health plans, and for leading the field-based Payer Relations team. The Director is responsible for the development of a comprehensive strategy for value-based partnerships that can enhance our presence with targeted health plans by engaging in direct and regular interaction with executive leadership. The role is also responsible for collaborating with global counterparts to ensure that payer engagement strategies and offerings are aligned with business goals across regions.The Director will drive the development and management of a U.S.-based team of Payer Relations professionals, responsible for all efforts to establish optimal coverage for procedures utilizing Boston Scientific focus technologies within targeted health plans.
Senior level development of key relationships at individual health plans.
Coordinating with Boston Scientific’s Corporate Accounts team to develop and execute on opportunities involving health plans owned by key IDNs.
Engaging with global counterparts to leverage ideas and programs and to ensure that pricing strategies, access strategies and programs are aligned and complementary.
Developing, modeling, analyzing and projecting the impact of core value-based partnership and market access strategies, especially coverage, for new and existing technologies, including whether there may be global opportunities or implications of said strategies.
Educating and engaging senior leaders within Boston Scientific on the importance and potential of stronger, value-based relationships with national payers and key IDNs to advance business objectives and solidify Boston Scientific’s leadership in value-based care.
Providing the “voice of the payer” to commercial team leadership, thus helping to ensure a sounding board for potential unintended consequences of key brand decisions.
Representing Boston Scientific at conferences and other gatherings, establishing Boston Scientific as a leader in value-based partnership with health plans.
Actively participating with leadership advancing Boston Scientific’s relationships with health plans as a value-based partner.
Leading and managing Payer Relations team within Health Economics and Market Access, whose responsibilities include development of insights, strategies, and tactics for reimbursement and access within targeted plans to include, but not limited to: coverage dashboards, payer team tools, provider access tools, payer team performance metrics, sales team messaging, access-related sales tools, issue triage.
Working cross functionally within the organization to achieve corporate goals and drive success.
What we’re looking for:
Basic Qualifications
A Bachelor’s degree (B.A. or B.S.) is required; advanced degree is preferred.
>15 years of payer relations and reimbursement experience within a relevant industry (e.g. diagnostics, managed care, medical device, etc.).
Deep knowledge of healthcare, marketing, managed care strategy, pricing and the medical reimbursement environment required.
An existing network of senior level executives within the private healthcare insurance industry and a strong reputation for effective execution of collaborative agreements that drive business.
Prior strategic account management responsibilities or equivalent relationship development or consulting experience with one of the following: payers, government agencies, IDNs, Accountable Care Organizations (ACOs).
Prior experience developing services and solutions focused on value-based healthcare.
Demonstrated experience solving complex problems and delivering significant value through diverse teams.
Proven ability to successfully execute a complex partnership process and interact with the C-suite.
Prior experience leading a geographically diverse, highly independent team, preferably in payer relations or coverage roles.
Platform presentation skills that make this individual a desired speaker at industry events in front of large groups.
Proven track record of influence management within a matrix environment.
Proven ability of successfully managing complexity, solving problems, and building strong relationships.
Ability to work well independently as well as collaboratively; self-motivated and disciplined to meet deadlines in the context of competing priorities and projects; lead and work effectively with cross-functional teams.
Ability to maintain and effectively deal with highly confidential matters.
Preferred Qualifications
Knowledge of Salesforce.com, or a similar Customer Relationship Management (CRM) platform, and other business programs.
Highly organized with ability to effectively manage multiple priorities in a fast-paced environment.
Must be able to travel (40%) as dictated by business need.
Strong written and oral communication skills.
Well-developed analytical and strategic skills.
Ability to model and live the corporate values.
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