Director, Payer Relations - Shockwave

Director, Payer Relations - Shockwave

Johnson and Johnson is currently seeking the best talent for a Director, Payer Relations - Shockwave within the Johnson & Johnson MedTech organization.

This is a field-based remote role available in all states / cities within the United States. While specific cities are listed in the Locations section for reference, please note that they are examples only and do not limit your application. We invite candidates from any location to apply.

Role Overview The Director of Payer Relations is responsible for developing and managing strategic relationships with national and regional health plans and other third-party payers. This role ensures that Shockwave Medical's products are positioned favorably with payers, networks, and reimbursement structures to maximize patient access and organizational revenue. The individual will also partner cross-functionally with members of the sales, marketing, and clinical affairs teams to inform the long-term evidence strategy required to obtain and maintain reimbursement in U.S. markets.

Key Responsibilities :

• Lead the development and execution of national and regional payer coverage and reimbursement strategies, including clinical data and publication requirements, health economics, and general value proposition models, to ensure successful payer negotiations, commercial viability, and improved patient access to covered IVL indications.
• Engage with third-party evidence review organizations to ensure up-to-date reviews of Shockwave clinical data and provide education and materials in support of positive conclusions from clinical literature.
• Develop and maintain strong relationships with target payers and build a working knowledge of their key processes including medical policy, utilization review, health outcomes, risk management, provider contracting, and claims processing.
• Develop relationships with Advisory Committee members and payer Medical Directors (key influencers for our indications) for public and private payers to support changes that reflect local medical practices.
• Influence policy development such as new Local Coverage Determinations (LCDs) and engage with various coverage advisory groups to enhance patient access.
• Effectively leverage and communicate published literature and other evidence to payers, demonstrating IVL value that positively influences coverage policy development.
• Monitor payer coverage policies, track review periods, and analyze data on medical review, prior authorization, and claims payment trends to inform payer strategy, tactics, and team priorities.
• Collaborate with Field Reimbursement Managers as needed for ongoing strategy execution.
• Support Clinical Education with lead local physician advocates to influence payer coverage and medical review policies.
• Improve effectiveness and focus of industry alliances, as needed, that support Medicare and commercial payer policy and patient access.
• Provide internal and external voice-of-customer (VOC) feedback to guide strategy development.
• Develop programs to train Sales Representatives and key economic customers on reimbursement issues.
• Perform other duties as assigned.

Qualifications :

The anticipated base pay range for this position is : Applicable Pay Range Bay Area : $168,000 - $271,400; US Country Norm : $137,00 - $235,750.

Additional Description for Pay Transparency : Employees are eligible to participate in the following Company sponsored employee benefit programs : medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance. Employees are eligible to participate in the Company's consolidated retirement plan (pension) and savings plan (401(k)). This position is eligible to participate in the Company's long-term incentive program. Employees are eligible for the following time off benefits : Vacation 120 hours per calendar year Sick time - 40 hours per calendar year; for employees who reside in the State of Washington 56 hours per calendar year Holiday pay, including Floating Holidays 13 days per calendar year Work, Personal and Family Time - up to 40 hours per calendar year Parental Leave 480 hours within one year of the birth / adoption / foster care of a child Condolence Leave 30 days for an immediate family member : 5 days for an extended family member Caregiver Leave 10 days Volunteer Leave 4 days Military Spouse Time-Off 80 hours