Regional Accounts Manager- West jobs in United States
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Koya Medical, Inc. · 18 hours ago

Regional Accounts Manager- West

Koya Medical, Inc. is a transformative healthcare company developing breakthrough treatments for venous diseases and lymphedema. The Regional Account Manager is responsible for securing and expanding payer access for Koya products by engaging with commercial health plans and Medicaid Managed Care Organizations, focusing on achieving favorable medical policy and in-network status.

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Responsibilities

Develop and execute payer access strategies for assigned regional health and Managed Medicaid plans
Engage key medical policy stakeholders to drive adoption and coverage of Koya’s products
Engage key payer contracting stakeholders to negotiate and establish in-network contracts for Koya’s products
Identify and resolve coverage and prior authorization barriers to product adoption and utilization
Serve as the primary point of contact for payer decision makers (medical directors, contracting, network management, policy teams)
Develop strong relationships with targeted payers and build a working knowledge of their key processes including medical policy, utilization review, provider contracting, quality management, and claims processing
Partner with Payer Relations/Payer Operations teammates for the development and execution of payer coverage, reimbursement, pricing, and contracting strategies in order to ensure commercial viability and improve patient access to novel therapies
Design and implement strategies that leverage KOL’s, patient advocacy groups, state regulations and clinical and economic data to secure favorable medical policy and coverage decisions from payer
Monitor competitors’ strategies and market dynamics to identify opportunities and threats in payer contracting and medical policy. Use insights to inform strategy and stay ahead in the market

Qualification

Market access strategyPayer contractingReimbursement strategyMedical policy developmentHealthcare industry experienceAnalytical skillsNegotiation skillsClinical acumenCommunication skillsPresentation skillsRelationship-building skillsProblem-solving abilitiesAttention to detailStrategic mindsetAdaptabilityTeam collaborationSelf-motivation

Required

Bachelor's degree in Life Science, Healthcare, Business or related field
Minimum of 5 years of experience in market access, payer contracting, reimbursement strategy, or related roles within the medical device/diagnostics/pharmaceutical industry
Demonstrated success securing positive medical policies, and driving in-network contracting with regional payers
Deep understanding of medical policy development, credentialing, contracting, and reimbursement processes across commercial, Medicare and Medicaid programs
Proven ability to manage multiple payer accounts and projects simultaneously with a focus on achieving measurable results
Strong clinical acumen with the ability to effectively communicate clinical and economic value to medical directors and other key payer stakeholders
Excellent negotiation, communication, presentation, and relationship-building skills
Strong analytical skills with the ability to analyze payer trends, competitive dynamics, and market access opportunities to inform strategy
Strategic mindset with the ability to work independently and drive results
Strategic, self-motivated, and results-driven, with strong problem-solving abilities and attention to detail
Ability to adapt to the fast-changing healthcare and reimbursement environment
Must be able to travel at least 30% of the time

Preferred

Experience with G Suite, Microsoft Office Suite, Adobe, Salesforce CRM, etc

Benefits

Base + bonus compensation package
Competitive benefits program

Company

Koya Medical, Inc.

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Koya Medical is a transformative healthcare company developing breakthrough treatments for venous and lymphatic diseases to increase movement, mobility and personalized care that is unavailable with traditional compression therapy.

Funding

Current Stage
Growth Stage
Total Funding
$70.22M
Key Investors
OrbiMed3×5 PartnersArboretum Ventures
2023-11-15Series C· $30M
2022-02-03Series B· $26M
2021-01-14Series A· $11M

Leadership Team

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Damian Rippole
Chief Operating Officer & Financial Officer
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Company data provided by crunchbase