Senior Health Economics & Reimbursement - Southeast

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Any US City
Job Type
Direct Hire
Dec 07, 2017
Job ID
GR Identifier: $Medd

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The successful candidate will be responsible for working directly with health care providers (hospitals and physicians) to ensure they understand and realize the economic value of the Transcatheter Heart Valve (THV) procedures. They will develop and deliver hospital economic analyses customized to each provider and will assist in the design and implementation of health economics research studies. They 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), Medicaid, Veteran Affairs (VA) and commercial payers.
This is a “Field” role with 50% - 70% travel requirement in Florida, South Carolina, Alabama, South Georgia, and Charlotte, NC. Also, consideration will be for those that live close to the following airports; Orlando, Tampa, and/or Atlanta due to the extensive travel that this position requires.
Essential job functions:
  • 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 evidence. 
  • Establish 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 plans (coding, coverage, payment) unique to each provider. 
  • Establish detailed understanding and ability to navigate regional payers (Medicare contractors and private insurers) coverage and payment processes. This will include ongoing monitoring of policy issues. 
  • Collaborate with internal Government Affairs and Reimbursement and Health Economics teams to develop advocacy relationships with regional KOLs and societies, trade party associations and other key third parties to influence outcomes of critical policy issues. 
  • Perform other duties and responsibilities as assigned. 
Required Education/Skills/Experience: 
  • Five+ years relevant work experience. For “field” role, desired experience in a field reimbursement role in industry.
  • 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.
  • Formal training or experience in health economics and/or outcomes research and reimbursement is a strong plus.
  • Bachelor’s degree in a life science, health economics, health policy, or related field. 
  • Advanced degree (e.g. MBA or MPH) is desirable
  • Excellent interpersonal skills, written and verbal communication skills, especially presentation development and delivery.
  • Ability to balance strategic thinking with intricate planning and strong tactical execution.