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ProfileDirector of Health Economics and Reimbursement The candidate will be responsible for educating hospitals and physicians regarding reimbursement, health care reform and billing practices to assist programs in establishing and maintaining appropriate reimbursement and economic awareness for all company products and services. The essential elements of this position is: model key components of a high functioning program across all company therapy lines; have an in-depth understanding of coverage, coding and payment models for all company products, and full command of the evolving Health Care Economic landscape as it relates to all Medical products and services. Develop and implement health economics and reimbursement activities for key administrative stakeholders. Provide Reimbursement Best Practices to new and existing company centers. Regularly present to a diverse audience, including C-suite executives, physicians, and service line administrators. Develop and implement reimbursement strategies and economic value plans to support physician and facility customers by identifying opportunities to partner with hospitals regarding the economics of company technologies and programs. Lead regional health care economic and reimbursement education for internal (sales and sales management) and external (hospitals, physicians, payers, etc.) stakeholders. Execute regional health economics and reimbursement programs including administrator/C-Suite focused conferences and symposia. Establish and maintain relationships with key economic decision-makers within defined strategic accounts. Inform the organization and educate key stakeholders on the impact of key health policy and macroeconomic changes; including, but not limited to, ACA, MACRA, bundled payments, ACOs, value-based purchasing, comparative effectiveness, and technology assessment. In collaboration with the Payer Relations team, partner with Accountable Care Organizations and State Health Exchanges to drive technology inclusion in Payer/Provider ACO contracts and utilization. Collaborate with Sale Leadership for all company therapy lines in the development and implementation of business plans for targeted accounts. Triage and prioritize requests from the U.S. sales organization to ensure that company strategic and operational plans are fully implemented. Measure and report on hospital financial viability to the Therapy Leaders for all therapy lines. Assist Area Vice Presidents, Regional Sales Directors and Regional Sales Managers in the development, implementation, and management of strategic initiatives within targeted accounts and geography. Regularly survey the market in an effort to understand the dynamics affecting U.S. businesses and to anticipate trends in the development of future innovative strategies and tactics to communicate the value of the company. Participate in cross-departmental meetings and conference calls for the purpose of providing input and guidance regarding market dynamics and issues needing focus, attention, and action. Act as the primary liaison for internal customers with respect to Health Economics and Reimbursement questions in the geographic area falling under the incumbent’s scope of responsibility. Utilize travel and entertainment budget within confines of allowable maximum budget. Comply with U.S. Food and Drug Administration (FDA) regulations, other regulatory requirements, Company policies, operating procedures, processes, and task assignments. Maintain positive and cooperative communications and collaboration with all levels of employees, customers, contractors, and vendors.
Qualification and Experience
Undergraduate degree from accredited college in relevant area required; advanced degree preferred (MHA, MBA, MS, PhD, and JD). 8-10 years of progressively advancing work experience in the following categories; Service line Administration, or C-suite experience in hospital, physician practice and/or payer setting; or prior industry Reimbursement and Health Care Economics Experience required. Experience in health policy, health economics, medical device reimbursement, technology assessment, health care marketing, research or regional sales/corporate accounts required. Understanding of medical / clinical research methods and publication interpretation and ability to use evidence to support value proposition required. Strategic thinker with experience implementing programs outside of direct reporting relationships and extensive presentation experience in front of a diverse audience, including C-suite executives, physicians, and service line administrators required. Experience in collaboration working across a matrix organization with various stakeholders required. Thorough understanding of public and commercial payer models, Reimbursement concepts (e.g., coverage, coding and payment) preferred. Relevant experience in reimbursement medical devices, with specific experience in cardiovascular diseases including Cardiac Rhythm Management, Heart Failure, and/or Mechanical Circulatory Support preferred.
Job ID: 30049783