Senior Field Reimbursement Manager - West
United States
Commercial – Commercial - US /
Full-time /
Remote
Based within the Market Access team, the field-based reimbursement manager role is responsible for working directly with hospitals and physicians to ensure they recognize the economic and clinical value of the Paradise ultrasound Renal Denervation System. Successful candidates will have excellent technical expertise in the areas of healthcare administration and delivery, facility and physician reimbursement, sales education and health economic value messaging. The right individual will exhibit outstanding communication skills, the ability to present complex information to a broad and diverse group of stakeholders, and the ability to convey the unique attributes of uRDN in the treatment of hypertension. This role is ideal for candidates who enjoy both strategy development and execution.
Responsibilities:
- In conjunction with sales colleagues, work directly with hospitals to evaluate reimbursement activities and broader financial environment relating to ultrasound renal denervation by analyzing key customer needs including coding (CPT, ICD-10, DRG), claims denials, procedural documentation
- Articulate a deep understanding of the commercial and government payer landscape including coverage policies and payment processes by identifying payer opportunities and issues and implement programs to resolve/mitigate barriers to entry for the Paradise system; this will include managing and addressing coverage policy issues with payers as necessary
- Establish and maintain effective working relationships with key stakeholders (including Cath Lab staff, billing, Administration and Physicians) at hospitals engaged in uRDN procedures, with the goal of supporting the site in to establish and maintain a uRDN program through development and implementation of tailored reimbursement plans addressing coding, coverage & payment
- Manage relationships with Commercial Insurance service carriers to optimize reimbursement environment and coverage for the Paradise system
- Present complex health economic information to influential and diverse groups in a way that is engaging, credible, and easily understood
- Create training materials and deliver education programs to sales force, physicians, medical directors, billing personnel, distributors, and other internal and external stakeholders as required
- Assist Regional/District Sales Managers in the development, implementation, and managements of strategic initiatives within geography. Support sales and clinical teams with reimbursement questions and challenges
- Utilize in-person & virtual meetings to educate and train sales team individually or in groups on health economic tools and messaging and the compliant use of economic tools
- Comply with U.S. Food and Drug Administration (FDA) regulations, other regulatory requirements, Company policies, operating procedures, processes, and task assignments
- Ensure compliance requirements for delivery of field or virtual reimbursement support services are fully met
- Serve as the field liaison to the Recor Market Access team by delivering customer insights, trends and challenges gathered from the field
- Experience with new technologies/therapies where coverage is provided on a case-by-case basis and has demonstrated effective partnership with Patient Therapy Access teams
Requirements:
- Previous experience or strong working knowledge of hospital finance or medical device industry specifically pertaining to health economics, reimbursement and service line implementation
- Minimum 8 years experience in field reimbursement roles for medical device companies
- A minimum of a Bachelors degree is required
- Comprehensive understanding of US health care policy and payment systems, including hospital and physician reimbursement
- Ability to review aspects of medical documentation and verify medical criteria as cases are reviewed
- Outstanding interpersonal skills, experienced developing relationships at all organizational levels to deliver business objectives
- Ability to balance strategic thinking with detail planning and strong tactical execution
- Demonstrates responsiveness and a strong sense of urgency
- Ability to prioritize work tasks and manage multiple priorities concurrently and meet deadlines
- Demonstrates comfort with ambiguity and the ability to adapt and refine continuously
- Experience and comfort with complex concept sales involving changes in customer behavior or care-pathway
- Ability to be perceived credibly and demonstrate excellent persuasion skills to achieve desired results
- Experience working functionally and cross-functionally
- Strong communication and collaboration skills
- Ability to work independently
- Travel: up to 70% of the time
$166,920 - $190,000 a year
(Commensurate with experience, skills, education, training and geographic location)
