Director of Reimbursement Policy and Strategy

Director of Reimbursement Policy and Strategy
Full Time – Exempt | Remote | Travel: ~20–30%

About the Role
NHIA is hiring a Director of Reimbursement Policy and Strategy to help advance fair, sustainable payment policy for home and alternate site infusion. Reporting to the Senior Vice President, Reimbursement Policy, this person translates Medicare, Medicaid, and commercial payer policy into actionable recommendations, engages directly with payers and state Medicaid programs on benefit design, and helps develop payment approaches that reflect the clinical and economic value of home infusion — working closely with NHIA members, policymakers, and other stakeholders along the way.

What You'll Do (Payer-Focused Highlights)

• Monitor and analyze Medicare, Medicaid, and commercial payer policy changes affecting home infusion, specialty pharmacy, DMEPOS, and alternate sites of care
• Develop evidence-informed policy and program recommendations for commercial payers, state Medicaid programs, and Medicaid managed care organizations
• Lead direct engagement with commercial payers and state Medicaid programs to advocate for sustainable reimbursement and coverage policies
• Design and advance alternative payment approaches, demonstrations, and value-based programs that showcase home infusion's value
• Draft comments on proposed regulations, payment rules, and payer policies
• Represent NHIA in meetings with payers, state Medicaid agencies, federal agencies, and coalition partners
• Serve as staff liaison to NHIA's reimbursement, regulatory, and public policy committees

Qualifications

• Bachelor's degree required (advanced degree in Public Policy, Health Policy, Healthcare Administration, Pharmacy, Public Health, Law, or Political Science preferred)
• 7–10+ years of progressive experience in healthcare payer policy, government health programs, managed care, or pharmacy benefits
• Government agency experience (DMEPOS, Medicare Part D, Medicaid pharmacy) or payer-side experience (health plan, PBM, Medicaid MCO) strongly preferred
• Proven ability to analyze complex payer reimbursement policy and turn it into practical recommendations
• Experience with payment models, benefit design, demonstrations, or value-based care initiatives
• Strong knowledge of Medicare, Medicaid, commercial insurance, and federal/state regulatory processes
• Excellent analytical, writing, presentation, and consensus-building skills