Payer Strategy & Operations Job at Stedi

Senior Director, US Market Access Strategy

Beam is looking for a strategic leader to drive market access strategy for key B...

Location

United States , Cambridge

Salary:

250000.00 - 310000.00 USD / Year

Beam Therapeutics

Expiration Date

Until further notice

Requirements

Bachelor’s required, Master’s preferred with 18+ years of experience
10+ years of experience in US Pharma, including at least 5+ years in payer strategy / marketing or payer account management
At least 3+ years of experience working in cell & gene therapies required
Proven track record of successful collaboration with cross-functional teams
Substantial experience in shaping market access and pricing strategies, developing brand plans & payer marketing tools (value proposition decks), informing HEOR data strategies, supporting field market access teams, etc.
Previous product launch experience in buy-and-bill products
Excellent communication (written, verbal and presentation), interpersonal influencing and prioritization skills required with proven ability to influence across matrixed organizations including influencing without authority
Proven ability to operate independently and handle multiple projects with a high degree of initiative including project planning and prioritization of competing demands
Willingness to work with ambiguity and candor
Experience developing and managing promotional budgets and managing third-party vendors

Job Responsibility

Create and own near/mid/long term access strategies focused on optimizing pricing and coverage
Monitor coverage environment for gene therapies and competitive landscape and coordinate cross functionally to ensure alignment
Drive cross-functional access strategy synergies with broader brand strategy
Collaborate with future market access team members, such as field team, trade & distribution lead, government affairs lead, and patient services lead
Own market access component of brand level strategic plans, ensuring alignment to brand objectives as well as near/mid/long term market access objectives
Partner closely with Value Evidence Strategy (VES) lead to ensure value prop and customer materials are backed by evidence and aligned with Medical Affairs
Develop access journey for brand, highlighting critical access components including pricing/contracting, channel strategy, payer strategy, patient services, enterprise strategy, etc
Support insights development including conducting primary market research to support the market access strategy and tactical planning
Monitor & synthesize syndicated market research and external environment, impacting pharmaceutical delivery and reimbursement including industry trends, public policy, and competitive landscape

Fulltime

Market Access Private Insurance Senior Manager

Join Amgen’s Mission of Serving Patients. At Amgen, if you feel like you’re part...

Location

Canada , Ontario

Salary:

149929.00 - 199919.00 CAD / Year

Amgen

Expiration Date

Until further notice

Requirements

Bachelor's degree in life sciences, business, health economics, or a related field
Minimum of 10 years of demonstrated experience working with or for private insurers and/or payer organizations
Demonstrated experience of working with or for a pharmaceutical/biopharmaceutical manufacturer, with a focus on market access, reimbursement, or private payer strategy
Recognized expertise in the Canadian private payer landscape, including insurers and PBMs
Strong, established relationships across the private insurance ecosystem
Deep understanding of drug reimbursement processes, pricing frameworks, and formulary decision-making
Proven experience leading payer negotiations
Demonstrated ability to operate strategically and influence at a senior level
Demonstrated ability to analyze complex data and translate insights into actionable strategies
Excellent communication, negotiation, and stakeholder management skills

Job Responsibility

Lead the development and execution of the Private Insurance strategic plan across the portfolio, including innovator and biosimilar products
Define and execute tailored payer strategies for key private insurance customers to optimize formulary positioning and maximize patient access across the Amgen portfolio
Own and deliver against private payer access objectives, including coverage, patient access, and financial performance
Generate and leverage data-driven insights to identify opportunities, shape strategy, and inform business decisions
Identify access barriers and implement solutions (e.g., coverage policy optimization, prior authorization support) to enhance patient access
Lead private payer strategy for new product launches and indications, ensuring timely, competitive, and sustainable coverage
Evolve payer strategies across the product lifecycle in response to market dynamics, competitive pressures, and policy changes
Strengthen and expand strategic relationships with key private insurance stakeholders, including insurers, pharmacy benefit managers (PBMs), brokers, plan sponsors, and other payer decision-makers
Represent the organization in external forums, industry associations, and working groups, demonstrating strong executive presence and reinforcing organizational credibility
Lead complex negotiations and strategic engagements with private payers to secure and sustain optimal access outcomes

What we offer

competitive and comprehensive Total Rewards Plans that are aligned with local industry standards

Fulltime

Accounts Director, Trusted Care Network

The Accounts Director, Trusted Care Network will serve as an individual contribu...

Location

United States

Salary:

135000.00 - 159500.00 USD / Year

Spring Health

Expiration Date

Until further notice

Requirements

8+ years of experience in health plan strategy, benefits consulting, enterprise sales, payer strategy, or healthcare operations
experience in benefits consulting, health tech or enterprise SaaS strongly preferred
Demonstrated commercial acumen, including experience supporting complex sales cycles, influencing buying decisions, and driving expansion within enterprise accounts
Strong understanding of employer-sponsored health plans, regulations, benefit design levers, and utilization management strategies
Proven ability to communicate value clearly to executive buyers, translating clinical or operational concepts into compelling business cases
Experience partnering with Sales and Customer Success teams to shape deal strategy, renewal positioning, and account growth plans
Exceptional executive presence, storytelling, and negotiation-influencing skills
Track record of cross-functional leadership across Product, Clinical Operations, Sales, and Customer Success
Entrepreneurial mindset with comfort operating in ambiguous, high-impact environments
Bachelor’s degree required

Job Responsibility

Own senior-level strategic relationships with enterprise customers and health plan stakeholders, serving as a trusted advisor who can influence benefit decisions, secure alignment on preferred plan designs, and drive utilization outcomes tied to commercial value
Partner with Sales and Customer Success teams on complex enterprise deals and renewals, shaping benefit design strategy, pricing narratives, and value cases that differentiate Spring Health and accelerate deal velocity, expansion, and long-term revenue growth
Design and operationalize utilization-driving strategies within preferred benefit designs (e.g., steerage models, benefit tiers) that directly support customer adoption, engagement, and ROI realization
Partner with Enablement and Product Marketing teams to create clear, compelling narratives, tools, and frameworks that help employers and payers understand how preferred plan design drives utilization, outcomes, and financial value
Translate commercial feedback, buyer objections, and customer requirements into actionable input for Product teams, shaping capabilities that remove friction in sales cycles and improve utilization post-sale
Represent Spring Health in executive customer meetings, advisory boards, and industry forums, positioning the company as a strategic partner and strengthening credibility in utilization-driven benefit design
Continuously synthesize customer insights, competitive dynamics, and market trends to inform sales strategy, positioning, pricing discussions, and future growth opportunities

What we offer

Health, Dental, Vision benefits start on your first day
HSA and FSA plans are also available, with Spring contributing up to $1K for HSAs, depending on your plan type
Employer sponsored 401(k) match of up to 2% for retirement planning
A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents
Competitive paid time off policies including vacation, sick leave and company holidays
At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents
Access to Noom, a weight management program
Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses
Access to Wellhub, which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription
Access to BrightHorizons, which provides sponsored child care, back-up care, and elder care

Fulltime

System Director Payer Strategy

As our System Director, Payer Strategy, you will play a key role in assisting wi...

Location

United States , Englewood

Salary:

80.17 - 119.26 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Bachelors Other or equivalent education and experience in payer strategy, managed care or provider network senior level role may be considered in lieu of degree.
Minimum of seven (7) years progressive leadership experience in the healthcare environment, of which five (5) years are in managed care contracting for a hospital, healthcare system, or health plans in an intensive managed care market

Job Responsibility

Leads in the development of National Payer strategy, relationships, and contracts with assigned National Payers to further drive a clear and effective negotiation strategy, reimbursement structure, contract renewal planning process, and contract implementation
Gathers information and drafts negotiation goal alignment with Division senior ministry leaders relative to the strategic, operational, and financial needs and expectations of each Division impacted by the National Payer
Establishes, builds, and maintains positive, strategic interactions and relationships with assigned National Payer(s), employers, providers, and leaders across the ministry
Documents Lessons Learned session following each renewal with their assigned National Payer with the PSR and PAE teams involved in the negotiations
Engages consistently in effective communication with internal stakeholders across the ministry to ensure key contract terms and requirements are successfully implemented
Develops and executes communication plans to internal and external stakeholders related to payer relationships, negotiations, organizational contractual obligations, and developments in the managed care marketplace
Works intimately with internal analytics teams
Analyzes and monitors financial aspects of existing managed care contracts and rate structure opportunities
Gathers feedback from ministry leaders on financial, revenue cycle, and operational issues with the National Payer related to contract renewals, renegotiations, payer compliance, or termination scenarios
Makes independent decisions and/or exercises sound judgment based upon appropriate information and objectives

What we offer

medical
prescription drug
dental
vision plans
life insurance
paid time off
tuition reimbursement
retirement plan benefit(s) including 401(k), 403(b), and other defined benefits offerings

Fulltime

Region Director Payer Analytics Economics-Mountain

As our Division Director, Payer Analytics & Economics, you will be accountable f...

Location

United States , Englewood

Salary:

66.26 - 98.56 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Bachelors Other Business Administration, Accounting, Finance, Healthcare or related field
Minimum of eight (8) years of experience in contributing to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations
Minimum of three (3) years of healthcare or financial leadership experience
Managed Care and Healthcare experience strongly preferred

Job Responsibility

Manage the labor and operations of the Division Payer Analytics & Economics team(s) including the hiring, orienting, developing and managing of staff
Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives
Review and accurately interpret contract terms, including payer policies and procedures to appropriately contract performance and influence strategic pricing strategies
Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability
Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes
Oversee and prepare complex service line reimbursement analyses and financial performance analyses. Develop methods and models (involving multiple variables and assumptions) to identify the implications/ramifications/results of a wide variety of new/revised strategies, approaches, provisions, parameters and rate structures aimed at establishing appropriate reimbursement levels. Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities

What we offer

medical, prescription drug, dental, vision plans, life insurance, paid time off, tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings

Fulltime

System Manager Payer Analytics Economics

Provide strategic leadership and expert oversight for all aspects of our organiz...

Location

United States , Englewood

Salary:

49.78 - 70.05 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Bachelors Other Business Administration, Accounting, Finance, Healthcare or related field or Equivalent education and experience in related field(s) may be considered in lieu of degree
Five (5) years of experience in contributing to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and/or healthcare operations
Two (2) years of experience in a supervisory role
Strongly prefer hospital or managed care experience
Strongly prefer some experience with SQL queries and strong Excel. EPIC experience a big plus.

Job Responsibility

Provide strategic leadership and expert oversight for all aspects of our organization's payer relations and contracting
Manage a team responsible for negotiating, implementing, and monitoring contracts with various governmental and commercial payers across our system
Manage the labor and operations of the Payer Analytics & Economics team including the hiring, orienting, developing and managing of staff
Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives
Review and accurately interpret contract terms, including payer policies and procedures to appropriately contract performance and influence strategic pricing strategies
Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability
Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes
Oversee and prepare complex service line reimbursement analyses and financial performance analyses. Develop methods and models (involving multiple variables and assumptions) to identify the implications/ramifications/results of a wide variety of new/revised strategies, approaches, provisions, parameters and rate structures aimed at establishing appropriate reimbursement levels. Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities.

What we offer

Medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings

Fulltime

Payer Business Development Lead

We are looking for a key team member to help support the build-out of Abridge’s ...

Location

United States , New York

Salary:

142000.00 - 166000.00 USD / Year

Abridge

Expiration Date

Until further notice

Requirements

5+ years in healthcare with experience spanning business development, product, partnerships, or strategy roles
Deep understanding of the payer landscape: health plan economics, value-based care, quality programs (HEDIS, Stars), utilization management, and revenue cycle management processes
Experience with revenue cycle management infrastructure and the knowledge of the tools, challenges and opportunities to innovate
Track record of building and closing complex enterprise healthcare deals with measurable revenue impact
Experience selling 0 to 1 : you've shaped what gets built, not just sold it
Relationships with health plan executives and/or health IT platform leaders
Experience building new business lines or verticals at growth-stage companies
Comfort with ambiguity and the ability to move fluidly between strategy, execution, and closing

Job Responsibility

Build and maintain strong relationships with payer organizations to drive new business and expand adoption of Abridge’s payer products
Support pipeline development by researching payer prospects, setting a sales strategy, and tracking engagement progress
Develop value propositions, pricing inputs, and ROI analyses for emerging payer offerings
Partner with Marketing to support payer-specific content, messaging, and conference preparation
Gather, organize, and synthesize payer feedback, market insights, and internal inputs to support product discovery
Track assumptions, dependencies, and open questions to drive cross-functional alignment and customer follow-up
Support testing and learning by helping coordinate pilots, early feedback loops, and documentation of outcomes
Support 0→1 product launches by coordinating across internal teams and customers to ensure smooth execution
Assist with refining early implementation needs, success criteria, and product experience as offerings mature
Identify recurring friction points and opportunities for process, communication, or tooling improvements

What we offer

Generous Time Off: 14 paid holidays, flexible PTO for salaried employees, and accrued time off for hourly employees
Comprehensive Health Plans: Medical, Dental, and Vision coverage for all full-time employees and their families
Generous HSA Contribution: If you choose a High Deductible Health Plan, Abridge makes monthly contributions to your HSA
Paid Parental Leave: Generous paid parental leave for all full-time employees
Family Forming Benefits: Resources and financial support to help you build your family
401(k) Matching: Contribution matching to help invest in your future
Personal Device Allowance: Tax free funds for personal device usage
Pre-tax Benefits: Access to Flexible Spending Accounts (FSA) and Commuter Benefits
Lifestyle Wallet: Monthly contributions for fitness, professional development, coworking, and more
Mental Health Support: Dedicated access to therapy and coaching to help you reach your goals

Fulltime

Director, Payer Policy

The Director, Payer Policy is responsible for shaping, influencing, and executin...

Location

United States

Salary:

164900.00 - 247000.00 USD / Year

NeoGenomics Laboratories

Expiration Date

Until further notice

Requirements

Bachelor’s degree in Business, Health Policy, Science, or related field required
Advanced degree (MBA, MPH, MHA, MS, PharmD, PhD) preferred
10 years’ experience required in of payer relations, market access, reimbursement, or managed care leadership, preferably within diagnostics, laboratory services, or biotech
Deep expertise in payer policy, coding, coverage frameworks, and reimbursement economics
Demonstrated experience influencing coverage decisions and navigating LBM organizations
Strong understanding of oncology testing, precision medicine, and relevant regulatory pathways
Proven track record of leading cross-functional teams in complex, matrixed environments
Experience shaping evidence strategy and collaborating with Medical Affairs/HEOR teams preferred
Experience in laboratory or diagnostic reimbursement environments preferred

Job Responsibility

Develop and execute a multi-year payer strategy to secure broad, durable coverage for NeoGenomics’ oncology diagnostic portfolio
Lead payer policy engagement, including proactive outreach, policy reviews, coverage advocacy, and targeted education on new and emerging technologies
Define and communicate NeoGenomics’ payer value proposition, leveraging clinical evidence, HEOR, real-world data, and patient outcomes
Partner with Medical Affairs, Clinical, and R&D to influence evidence plans needed to support positive coverage decisions
Oversee payer policy monitoring and regulatory surveillance
communicate changes and recommended actions to internal stakeholders
Ensure payer contracts, policies, and billing operations are fully aligned to maximize reimbursement yield and reduce leakage
Advocate directly with payer Medical Directors, policy teams, and LBMs to support positive coverage and overturn restrictive decisions
Develop and present scientifically grounded, evidence-based dossiers and materials tailored to payer needs
Support preparation of clinical, economic, and outcomes evidence that strengthens the payer value story

What we offer

Career coaches
Many training opportunities
Highly competitive benefits with a variety of HMO and PPO options
Company 401k match
Employee Stock Purchase Program
Tuition reimbursement
Leadership development
16 days of paid time off plus holidays
Wellness courses
Highly engaged employee resource groups

Fulltime

Select Country

Payer Strategy & Operations

Stedi

Location:
United States

Category:
IT - Software Development

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 18, 2026

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