Director, National Payer Accounts

Boston, Massachusetts, Location: Boston, MA Company Overview We are a healthcare technology company with validated science, real-world impact, and strong momentum. As we scale that impact, we are building the team and systems to ensure rapid, high-quality execution within a regulated environment. Where You Fit This role will lead our work with commercial health plans to secure coverage for Clairity Breast, our FDA authorized, image based breast cancer risk assessment. As the executive relationship owner for a portfolio of national and regional payers, including the administrators of self insured employer plans, you will be responsible for moving plans from first conversation to published medical policy and payment, measured by the number of covered lives with access to Clairity Breast. You will work closely with Clinical, Product, and Marketing to build the evidence and economic case for each plan, win the support of medical directors and technology assessment committees, and turn coverage decisions into access for the women who need earlier, more personalized screening. This role is based in Boston with a national scope and reports to the Vice President of Market Access. What You’ll Do

Build and manage a payer pipeline, maintain an accurate forecast of coverage decisions, and deliver against annual covered lives targets. Secure positive medical policy for Clairity Breast by developing and executing a coverage plan for each account, from initial engagement through technology assessment, policy publication, and implementation, and broaden coverage criteria over time as the evidence base grows. Grow coverage across fully insured and self insured employer segments, working with carriers, ASO and TPA administrators, large employers, and their benefits consultants. Own executive and clinical relationships across a portfolio of national and regional commercial health plans, including national carriers, regional plans, and provider sponsored plans, identifying and developing champions among medical directors, technology assessment committees, and clinical policy teams. Build and maintain the payer economic case, including budget impact models, evidence dossiers, and value presentations tailored to each plan’s population and priorities, working with Clinical and outside partners as needed. Negotiate per test pricing and contracting terms in partnership with commercial leadership. Mobilize provider partners and clinical champions to generate plan specific demand and demonstrate real world value. Convert coverage into paid claims by working with plans and provider partners on provider education and resolving authorization or claims issues. Deliver actionable payer feedback to Clinical, Product, and Evidence teams to shape future studies and positioning.

What You Bring Required

8+ years of experience in payer account management, market access, or health plan engagement, with a demonstrated track record of securing positive coverage decisions or medical policy for diagnostics, medical devices, or digital health technologies. Active working relationships with medical directors, clinical policy leaders, or other coverage decision makers at national and regional health plans. Deep understanding of how commercial health plans evaluate new technologies, including technology assessment processes, evidence standards, and medical policy development. Hands on ability to build health economic materials, including budget impact models and payer value dossiers, and to present them credibly to medical directors. Working knowledge of coding, coverage, and payment, and how they interact in bringing a new test to market. Excellent communication, negotiation, and cross functional leadership skills, with the ability to present clinical and economic evidence to physician audiences. High ownership mentality; ability to move quickly with judgment and data driven decision making, and proven ability to deliver to targets. Ability to travel approximately 30 to 50%.

Nice to Have

Advanced degree (MBA, MPH, MHA, or clinical degree). Experience in breast imaging, oncology, radiology, or commercializing AI enabled technologies. Prior experience working at a health plan, particularly in medical policy, technology assessment, utilization management, or network contracting. Experience securing coverage for a new test or technology category without existing payer policy. Experience working with self insured employers, benefits consultants, or third party administrators. Understanding of federal and state programs, including Medicare, Medicare Advantage, and Medicaid managed care. Experience with radiology benefit managers and imaging utilization management criteria. Formal training or experience in health economics and outcomes research, and familiarity with value based arrangements. Plus variable incentive opportunity and equity