Director of Payer Relations at ROMTech (2024-11 – Present)
- Spearheaded national and regional market access strategies for legacy and pipeline healthcare solutions, expanding commercial payer coverage by 25% and accelerating guideline inclusion.
- Cultivated strategic C-level relationships with CMOs and Medical Directors at elite teaching institutions including Cleveland Clinic, Shands, and Mass General Hospital to secure positive clinical advisory outcomes.
- Built and directed a high-performing regional Payer Relations team, optimizing cross-functional collaboration with Sales and Key Opinion Leaders (KOLs) to streamline the regional claims pipeline.
- Formulated targeted policy and coding strategies, resulting in a 30% reduction in reimbursement delays and driving an 18% increase in approved utilization management guidelines.
Director of Market Access at Great Lakes Neurotechnologies (2022-02 – 2024-12)
- Spearheaded market access and reimbursement strategies for the KinesiaU Parkinson's portfolio, expanding commercial and CMS payer coverage by 35% to accelerate patient access across key U.S. markets.
- Secured favorable coverage policies by driving critical clinical advisory meetings with commercial payers and Medicare Administrative Contractors (MACs), increasing reimbursement approvals by 28%.
- Educated and aligned community Neurologists and Key Opinion Leaders (KOLs) on product clinical significance, reducing claim denials by 25% and improving payment turnaround times by 20%.
- Leveraged value-based evidence and payer insights at national healthcare conferences to influence Chief Medical Officers (CMOs), driving a 30% increase in product utilization and long-term revenue growth.
National Director of Health Policy/ Reimbursement at RTI Surgical (2019-03 – 2022-01)
- Spearheaded national health policy and market access strategies for a high-growth startup environment, expanding commercial and CMS coverage by 35% to drive multi-million-dollar revenue growth.
- Overturned entrenched "experimental/investigational" designations, successfully positioning Cortiva as a Medically Necessary benefit with major national and regional payers.
- Orchestrated peer-to-peer virtual conferences between Chief Medical Officers (CMOs) and internal clinical teams, improving overall coverage outcomes by 30% and accelerating provider adoption.
- Collaborated closely with Regulatory and Key Opinion Leaders (KOLs) to audit hospital coding systems, reducing complex claim denials by 25% and increasing overall reimbursement success rates by 20%.
East Coast Market Access/ Reimbursement/ Policy at Vascular Insights (2015-02 – 2019-02)
- Spearheaded East Coast market access strategies for a specialized vascular catheter through a major corporate acquisition, expanding regional patient access by 35% and accelerating therapy adoption by 28%.
- Secured 15 commercial payer agreements to conduct non-scheduled policy reviews, successfully overturning negative policies through targeted peer-to-peer clinical presentations.
- Supported 1 regional LCD (Local Coverage Determination) with MACs, driving a 25% increase in approved claims and establishing critical commercialization pathways.
- Partnered with 8 Northeast regional sales reps and Key Opinion Leaders (KOLs) to train billing managers on complex appeals and denials, reducing claim denial rates by 20%.
