Healthcare Payer Lead

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Healthcare Payer Lead

At Roche Diagnostics we are transforming diagnostics into an intelligent data-driven system of care powered by AI and digital solutions. To succeed our products must not only demonstrate clinical value but also fit into real-world healthcare economics reimbursement logic and payer decision-making frameworks.

The Opportunity

Transform the economics of healthcare!

The Healthcare Payer Lead ensures that our digital and AI-enabled solutions are designed with a deep understanding of payer systems economic incentives and value-based care modelswith a particular focus on the United States and scalability across global markets.

Reporting to the Chapter Lead for Clinical Design the Healthcare Payer Lead will:

• Build and disseminate deep understanding of the healthcare payer landscape including value-based care and reimbursement dynamics
• Assess and articulate payer value created by clinician use of our solutions translating it into evidence value propositions and monetization pathways
• Shape reimbursement and market access strategies by aligning clinical outcomes economic value and real-world adoption in collaboration with the market access & GTM teams
• Engage and cultivate strategic relationships with payers and external stakeholders to inform product evidence and go-to-market strategies
• Integrate payer perspectives into product development clinical strategy and cross-functional decision-making across global and local teams

Key responsibilities:

Payer Knowledge & Thought Leadership

• Drive initiatives to deepen organizational knowledge of healthcare payers value-based healthcare and hospital economics
• Represent and disseminate payer-related insights across internal stakeholders
• Support development of payer-relevant marketing and thought leadership materials

Payer Engagement & Market Insight

• Build and maintain strategic relationships with healthcare payers payviders and external stakeholders
• Engage with the healthcare system to assess payer needs priorities and evolving payment models
• Lead and/or support advisory boards and payer-focused engagements

Value Articulation & Evidence Translation

• Assess and articulate the payer value generated through clinician use of our products (e.g. outcomes cost utilization)
• Translate product and clinical capabilities into payer-relevant value propositions and evidence requirements
• Provide iterative feedback during product development to strengthen payer value

Reimbursement & Market Access Support

• Inform evidence and value requirements for reimbursement and coverage decisions
• Contribute payer insights to emerging payment and coverage models
• Support the development of scalable reimbursement pathways and monetization strategies across markets
• Partner with GTM Market Access and Policy teams to align on access strategies

Clinical Strategy & Cross-functional Integration

• Contribute to and help shape clinical strategies with a payer and health economics perspective
• Translate clinical challenges and customer pain points into payer-relevant value opportunities
• Collaborate with product medical UX and evidence generation teams to embed payer perspectives into solution design and validation
• Support alignment between global and regional teams to ensure consistent payer-relevant positioning and knowledge exchange

Who You Are

• Educational requirements:
  • Bachelors degree 7 years relevant experience or
  • Masters degree 5 years relevant experience or
  • Doctorate 3 years relevant experience
• Extensive experience working within a healthcare payer payvider or healthcare system organization
• Experience in the health & life sciences industry

• Strong customer orientation and deep understanding of healthcare payers and payviders across global markets including the U.S.
• Strong understanding of reimbursement models and market trends (VBHC FFS capitation public vs. private) as well as healthcare IT (e.g. remote patient monitoring clinical decision support workflow solutions)
• Ability to quantify and articulate payer value including impact on cost utilization and clinical outcomes
• Ability to translate clinical and product capabilities into payer-relevant evidence and economic value propositions (HEOR mindset)
• Experience in shaping or enabling reimbursement pathways and value-based payment models for digital or clinical solutions
• Ability to translate healthcare payer considerations into technical and product requirements
• Ability to flex and thrive in an ambiguous environment
• Effective in collaborating with internal and external stakeholders across functions
• Experienced in engaging with hospital and payer C-suite stakeholders
• Strong communication and presentation skills with the ability to synthesize complex topics into clear decision points
• Strong business acumen with a solid understanding of industry dynamics competitors and market forces
• Ability to manage multiple priorities effectively and efficiently
• Strong interpersonal influencing and negotiation skills; able to build trust quickly and drive outcomes without formal authority

Preferred:

• Experience with reimbursement coverage or value-based payment models
• Experience with digital health AI-enabled solutions or healthcare software products
• Experience working cross-functionally with product clinical or commercial teams

• Experience with the U.S. healthcare system
• Experience in healthcare IT
• Qualifications related to agile methodologies and/or project management

The expected salary range for this position based on the primary location of Indianapolis IN is between $148800 - $276300. Actual pay will be determined based on experience qualifications geographic location and other job-related factors permitted by law. A discretionary annual bonus may be available based on individual and Company performance. This position also qualifies for the benefits detailed at the link provided below.

Benefits

Relocation benefits are not available for this job posting.

A healthier future drives us to innovate. Together more than 100000 employees across the globe are dedicated to advance science ensuring everyone has access to healthcare today and for generations to come. Our efforts result in more than 26 million people treated with our medicines and over 30 billion tests conducted using our Diagnostics products. We empower each other to explore new possibilities foster creativity and keep our ambitions high so we can deliver life-changing healthcare solutions that make a global impact.

Lets build a healthier future together.

Roche is an equal opportunity employer. It is our policy and practice to employ promote and otherwise treat any and all employees and applicants on the basis of merit qualifications and competence. The companys policy prohibits unlawful discrimination including but not limited to discrimination on the basis of Protected Veteran status individuals with disabilities status and consistent with all federal state or local laws.

If you have a disability and need an accommodation in relation to the online application process please contact us by completing this form Accommodations for Applicants.