Director of Market Access and Reimbursement

ZOLL Medical•Atlanta, GA

8d•Remote

About The Position

At ZOLL Itamar, we are dedicated to improving patient outcomes and saving lives through innovative medical technologies. Our focus is on developing and manufacturing Home Sleep Apnea Tests, with our core product being the WatchPAT®️ family, a leading FDA-cleared portable device for diagnosing respiratory sleep disorders. We aim to reach undiagnosed patients, promoting wellness and enhancing quality of life. WatchPAT®️ is commercially available in major markets including the U.S., Japan, and Europe, and is the leading home sleep apnea test in the US. ZOLL Itamar’s corporate headquarters, research and development and manufacturing are located in Israel with U.S. headquarters based in Atlanta, GA. This remote position is responsible for the coordination and growth of market access and reimbursement initiatives in North America (US & Canada). The role involves managing the US reimbursement team and consultants, handling tactical issues like denials and billing, and engaging with payers on higher-level reimbursement discussions. The Director will lead the monitoring and updating of payer policies to improve product coverage and reimbursement rates, requiring independence, proactivity, creativity, and a strong understanding of the reimbursement regulatory landscape. Close collaboration with the sales organization, leadership team, Regional Sales Managers, and other field professionals is expected. The position reports to the VP Strategic Planning & Health Economics.

Requirements

Bachelor's Degree in health-related or similar field required
5+ years of reimbursement or comparable experience preferred
Proven experience dealing with insurance companies and payors.
Experience in Cardiovascular or Sleep Apnea - required.
Proven negotiating and customer relationship management skills with the ability to navigate a complex process.
Ability to effectively manage assigned accounts in terms of problem resolution and business planning.
Proven effective verbal, computer SW (word, PP etc.), written and presentation/communication skills.
Ability to quickly adapt and respond to job, environmental, and industry changes.
Ability to lead others to accomplish work, while monitoring and mentoring them.
Strong customer service skills, with excellent written & verbal communication skills.
Strong analytical skills.
Must be able to communicate effectively & maintain professional conduct at all times.
Organized, self-starter with the ability to handle numerous projects and prioritize workload with minimal supervision.

Nice To Haves

Professional Coding Certification highly preferred
Experience with reimbursement of medical devices – preferred.
Experience in working with specific tools monitoring payers’ policies such as “Policy Reporter” or others.

Responsibilities

Understand and follow reimbursement guidelines and policies, including timely updates and communication of changes affecting reimbursement to management.
Keep track of payers’ policies and coverage of our products, identify restrictions, and determine if changes are needed to improve reimbursement.
Monitor and analyze relevant guidelines and provide published data to company staff.
Provide data to address reimbursement challenges, such as product utilization (and competitors'), and number of covered lives per payer.
Contact and negotiate with insurance companies regarding denials and policy issues.
Develop and execute a market access and reimbursement strategy in Canada to approve product coverage.
Support the ZOLL IDTF reimbursement team to increase coverage and reimbursement rates in IDTF contracts with payers.
Responsible for all reimbursement training for new hires, specifically in the field force.
Serve as the point of contact for the field force (ABDs, RSMs) and others needing to understand coverage issues or encountering reimbursement problems.
Manage the US reimbursement team to resolve field reimbursement issues and support the field force.
Address denials, including understanding the reasons and solutions.
Educate providers about home sleep testing reimbursement.
Provide timely and effective solutions aligned with company needs.