Senior Director Reimbursement
heor
Job description
This is where your work makes a difference. At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride. This is where you save and sustain lives At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride. Summary The Senior Director, Reimbursement – Front Line Care (FLC) leads multiple teams to define and execute the reimbursement, market access, and health policy strategy across Baxter’s Front Line Care portfolio. This leader oversees four core functions—Market Access, Payer Enrollment & Contracting, Federal Government Programs, and State Government Programs. This role drives reimbursement strategy across commercial and government payers, ensuring optimized coding, coverage, and payment for current and pipeline products, while shaping policy and advocacy efforts to remove barriers to patient access. Essential Duties and Responsibilities Strategic Leadership & Governance · Define and lead the enterprise reimbursement and market access strategy for the FLC portfolio, ensuring alignment with business growth objectives. · Serve as a key member of the leadership team, advising on pricing, access, reimbursement, and policy implications across the product lifecycle. · Translate evolving payer, regulatory, and policy landscapes into actionable strategic direction for current and pipeline products. Market Access Leadership · Oversee development and execution of US and OUS market access strategies, including coding, coverage, and payment initiatives. · Guide payer-facing value proposition development using clinical, economic, and outcomes data. · Lead strategic engagement with national, regional and local payers to expand coverage and reduce patient access barriers. · Ensure cross-functional alignment with Commercial, Medical Affairs, HEOR, Government Affairs, R&D, Legal, and Compliance. Payer Enrollment & Contracting · Direct payer contracting strategy across commercial and government channels, including negotiation of rates, terms, and network participation. · Oversee enrollment and credentialing strategy to ensure compliance and speed-to-access with commercial payers and government programs. · Establish operational excellence in contracting lifecycle management, payer onboarding, governance, and issue resolution. · Responsible for final review and signature of Payer contracts as an authorized signer of the company. Federal Government Programs · Lead reimbursement strategy and compliance for federal programs, including Medicare (CMS), TRICARE, and federal marketplace programs as applicable. · Serve as an enrolled, authorized representative of the company and signer of enrollment agreements with CMS, accrediting bodies and licensing agencies. · Monitor CMS rulemaking, federal policy changes, and payment methodology updates; lead organizational response and advocacy. · Oversee development of coding, coverage pathways, reimbursement positioning, and evidence requirements for new technologies. State Government Programs · Direct Medicaid strategy across states, including coverage expansion, enrollment requirements, and participation requirements. · Serve as an enrolled, authorized representative of the company and signer of enrollment agreements with Medicaid programs. · Lead engagement with state agencies, Medicaid decision makers, and policy stakeholders to shape reimbursement frameworks. · Ensure compliance with state-specific regulatory and payment requirements and proactively remediate access risks. People Leadership & Organization Development · Lead, coach, and develop a team of Directors and their organizations across all reimbursement functions. · Build organizational capabilities in payer engagement, contracting strategy, government policy navigation, analytics, and compliant execution. · Foster a high-performance, inclusive, compliant, and collaborative culture aligned to Baxter’s values and business priorities. External Engagement & Advocacy · Build and maintain executive-level relationships with payers, government policy makers, advocacy groups, industry associations, and key opinion leaders. · Lead industry engagement to influence reimbursement policy and remove barriers to patient access. · Represent Baxter externally in reimbursement, payer, and policy forums as appropriate. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Education and/or Experience · Bachelor’s degree required in healthcare, business, economics, public health, health policy, finance, or related field; advanced degree preferred. · 12–15+ years of progressive experience in healthcare reimbursement, market access, health policy, payer strategy, government programs, or related commercial / access leadership roles. · 10+ years of leadership experience managing multi-functional teams, Director-level leaders, or complex matrix organizations. · Demonstrated success in reimbursement development, including coding, coverage, and payment strategies across commercial and government payers. · Experience in medical device, digital health, diagnostics, respiratory health, cardiology, or adjacent healthcare technology markets preferred. Knowledge, Skills and Abilities · Deep expertise in Medicare, Medicaid, commercial and regional payer systems, federal and state government programs, payer contracting, and healthcare policy. · Prior experience establishing reimbursement in International markets. · Strong knowledge of CPT/HCPCS coding, payment systems, coverage policy, regulatory requirements, third-party billing, appeals, and payer audits. · Proven experience negotiating payer contracts, influencing coverage decisions, and building payer / policy maker relationships. · Ability to interpret complex federal and state payer
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