Senior Manager, Global Health Economics and Reimbursement (US)

13 Nov 2024

Vacancy expired!

The Senior Manager, Global Health Economics and Reimbursement is a field based role responsible for working directly with hospital executives, cardiovascular service line leaders and physicians to ensure they recognize the economic and clinical value of the transcatheter heart valve (THV) therapies. They will work directly with these leaders to deliver hospital economic and quality analyses customized to each provider. This individual will also support the health care providers in obtaining optimal reimbursement (payment rates and market access) by serving as an expert resource in coding, coverage and payment, as well as, an intermediary to payers including Center for Medicare Services (CMS) and/or Medicare Administrative Contractors (MAC), Medicaid, Veteran Affairs (VA) and commercial payers. This individual will work directly with regional, government and commercial payers to address denials and access to care issues.This individual will be located in the field supporting a six to eight state geographical area (TBD). The Senior Manager, Global Health Economics and Reimbursement will report to the National Director, Global Health Economics and Reimbursement.Primary Responsibilities:Ensure THV value messages are consistently developed and delivered, and customer feedback on value proposition is communicated to internal THV leadership. This will necessitate a competence in developing, synthesizing, and presenting health economic analytics.

Establish and maintain effective working relationships with key stakeholders at hospitals engaged in THV procedures, including OR and cath lab staff, billing, administration and physicians (interventionists and surgeons), to support the site in establishing and maintaining a THV program through the development and implementation of reimbursement and quality improvement plans (coding, coverage, payment public reporting) unique to each provider.

Ability to articulate a thorough understanding of the commercial and government payor landscape including coverage policies and payment processes. This will include managing and addressing coverage policy issues with payors as necessary.

Build a strategic relationship and serve as a supporting role to our aligned business partners including sales, marketing, government affairs, and medical/clinical affairs.

Assist our Regional and Territory Sales Managers in the development, implementation, and managements of strategic initiatives within geography.

Ability to travel up to 50% of the time within their determined region.

Perform other duties and responsibilities as assigned.

Basic Qualifications:Bachelor’s degree in a life science, health economics, health policy, or related field

Minimum of 12 years of experience. E.g. Experience in health policy, health economics, medical device reimbursement and technology assessment.

Minimum of 3 years of work experience in a field base reimbursement role or sales role within the healthcare industry.

Understanding of medical and clinical research methods and publication interpretation with ability to use evidence to support value proposition.

Preferred Qualifications:Master’s degree in a life science, health economics, health policy, or related field and minimum of 10 years of experience is preferred.

Strong understanding of the commercial insurance landscape and relevant reimbursement processes. A solid understanding of public payer programs; e.g. CMS, including coverage, coding, and payment policies, is also required.

Strong business acumen, analytical skills, and experience working with various internal business partners (especially Sales, Marketing, Clinical, Regulatory, Legal, and Government Affairs staff) to provide insight into key economic and reimbursement issues for transcatheter heart valve products.

Ability to build and maintain strong relationships with hospital and physician leaders.

Proficient in Microsoft Office Suite (i.e. Excel, PowerPoint, Word, Outlook).

Excellent interpersonal skills, written and verbal communication skills, especially presentation development and delivery.

Edwards is committed to complying with the requirements and guidance from our government authorities and to protecting our vulnerable patients and the healthcare providers who are treating them around the world. As such, all patient-facing and in-hospitals positions require COVID-19 vaccination, which includes anyone who directly interfaces with patients and those who enter a hospital or healthcare facility as part of their role. If hired, as a condition of employment, you will be required to submit proof that you have been fully vaccinated for COVID-19 or have a valid religious or medical exemption from being vaccinated.Edwards is an Equal Opportunity/Affirmative Action employer including protected Veterans and individuals with disabilities.Edwards is committed to complying with the requirements and guidance from our government authorities and to protecting our vulnerable patients and the healthcare providers who are treating them around the world. As such, all patient-facing and in-hospitals positions require COVID-19 vaccination, which includes anyone who directly interfaces with patients and those who enter a hospital or healthcare facility as part of their role. If hired, as a condition of employment, you will be required to submit proof that you have been fully vaccinated for COVID-19 or have a valid religious or medical exemption from being vaccinated.Edwards Lifesciences is the global leader in patient-focused medical innovations for structural heart disease, as well as critical care and surgical monitoring. Driven by a passion to help patients, the company collaborates with the world's leading clinicians and researchers to address unmet healthcare needs, working to improve patient outcomes and enhance lives. Headquartered in Irvine, California, Edwards Lifesciences has extensive operations in North America, Europe, Japan, Latin America and Asia and currently employs over 15,000 individuals worldwide.For us, helping patients is not a slogan - it's our life's work. From developing devices that replace or repair a diseased heart valve to creating new technologies that monitor vital signs in the critical care setting, we focus on helping patients regain and improve the quality of their life.

Full-time
  • ID: #22691789
  • State: Maryland Remote 00000 Remote USA
  • City: Remote
  • Salary: USD TBD TBD
  • Showed: 2021-11-13
  • Deadline: 2022-01-12
  • Category: Et cetera