Head of Payer Relations & Reimbursement Strategy

In April 2025, Kandu Health and Neurolutions merged to form Kandu Inc. to pioneer an integrated approach to stroke recovery, combining FDA-cleared brain-computer interface technology with personalized telehealth services. The company’s IpsiHand® device is durable medical equipment that enables chronic stroke survivors to regain upper extremity function in daily home use. Combining this  advanced technology with the support of expert clinicians offers a comprehensive path to recovery– helping survivors improve mobility, independence, and quality of life. Kandu extends recovery beyond the hospital through principal illness navigation, providing one-on-one education, care coordination, and advocacy; grounded in clinical evidence and informed by the lived experiences of patients and their families.

The Head of Payer Relations & Strategy will architect and lead enterprise payer strategy and reimbursement operations. Reporting to the CEO, this executive will create and execute a multi-year roadmap to secure prior authorizations, cultivate senior payer relationships, and drive payment success across Medicare, Medicare Advantage, Medicaid, and commercial insurers. The role sets segmentation and policy priorities, approves negotiation frameworks, and builds a scalable access organization that makes our therapy broadly accessible and affordable.

What You’ll Do 

Strategic Leadership

• Develop and lead the comprehensive payer and market-access strategy & operations for the company’s current and pipeline products.
• Serve as the internal expert on payer policy, reimbursement trends, and regulatory dynamics for durable medical equipment and digital health services.

• Stay current on state and federal policy changes and convert them into strategic growth recommendations.
• Lead payer segmentation, targeting, value-proposition development, and contracting prioritization, delegating tactical execution as needed.
• Develop strategies to optimize market access and reimbursement rates; ensure plans feed directly into corporate forecasts and operating plans.
• Monitor payer policies, market trends, and competitive moves to surface risks and opportunities.
• Direct coverage-policy, coding, and pricing analyses to support current and future products.

Payer Engagement

• Bring established relationships with key decision makers at leading commercial and government health plans—executives, medical directors, policy committees, and case managers—and expand these networks to accelerate adoption.
• Drive contracting efforts, including gap exceptions and single-case agreements, with a goal of achieving in-network status on favorable terms.
• Design and deliver educational programs that highlight the clinical and economic value of the company’s therapies.

Operational Execution

• Develop a three-year blueprint for benefit verification, prior authorization, appeals, and billing/collections that can scale efficiently with projected year-over-year growth, including scenarios that double current volume.
• Identify process gaps and close them via technology, automation, or strategic partnerships; ensure consistent adoption of new procedures across all teams while overseeing day-to-day execution.
• Maintain audit-ready documentation and controls, ensure proactive compliance with all payer and regulatory requirements, and own the functional budget and staffing plan.

Evidence & Policy

• Collaborate with Clinical and Medical Affairs to convert outcomes data into payer-ready dossiers.
• Partner with external advisors and KOLs to develop medical-necessity criteria and secure favorable policy inclusion and coverage determinations.

Cross-Functional Collaboration

• Align Sales, Marketing, Clinical, and Product functions with market-access strategy.
• Influence product design and go-to-market plans with payer and provider insights, and participate in budget and forecasting efforts to ensure accurate payment timing and revenue projections.

Metrics & Reporting

• Define and track KPIs such as prior-authorization approval rate, time to payment, overturned-denial percentage, and payer-specific conversion.
• Analyze marketing and relationship spend for ROI, and provide regular updates to the executive team and Board.
• Collaborate with Finance to produce investor-level dashboards covering coverage milestones, reimbursement performance, and forecast variance.

• 8+ years in healthcare reimbursement, market access, or payer contracting—ideally in medical devices, durable medical equipment or digital therapeutics.
• Demonstrated success launching novel therapies with new HCPCS or CPT codes and achieving national coverage.
• Deep knowledge of CMS policy, HCPCS coding, and payer dynamics, with extensive experience negotiating at the Medicare Advantage and large commercial-payer level.
• Executive presence and a history of Board and investor presentations.
• Proven ability to build and lead high-performing market-access and revenue-cycle teams.
• Experience with CMS CED Programs a plus.

What We Offer

• Competitive Compensation ($200,000 - $250,000 DOE + bonus)
• Insurance (Medical/Dental/Vision)
• 401(k) with company 
• Unlimited PTO & Holidays
• Life Insurance, LTD and STD

Please note that the salary information is a general guidance only. Kandu Health, Inc. considers factors such as scope and responsibilities of the position, candidate’s work experience, education/training, key skills and internal parity, as well as location, market and business considerations when extending an offer.

Kandu Health is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.