Field Reimbursement Manager (West, US)

Smith+Nephew•San Francisco, CA

1d•$130,000 - $150,000

About The Position

Reporting to the Director of Reimbursement & Market Access, ENT, the Field Reimbursement Manager will support the day-to-day reimbursement and market access needs for both internal and external customers. The Field Reimbursement Manager will be responsible for implementing and managing Patient Access Programs that build the foundation of market adoption. This includes training, education, and oversight of programs. What will you be doing? The Field Reimbursement Manager will use analytical skills to solve reimbursement issues and train customers on billing practices. They'll partner with physicians, hospitals, and sales teams to address coding issues and provide reimbursement support, including, but not limited to, assisting customers with understanding escalated cases, benefit verification, prior authorization coordination, payer issue resolution, and ongoing case management to ensure timely access to care. They'll develop coverage strategies, particularly for in-office procedures. Collaborating internally, they'll help implement coding and payment strategies for ENT products. Responsibilities include educating customers on payer trends, supporting practices in their reimbursement activities, escalating payer issues to payers, assisting in developing educational tools, and reporting on reimbursement initiatives. What will you need to be successful? Success in this role depends on a commitment to developing technical expertise in the ENT portfolio through structured training and assessments and building rapport with Sales Representatives and leadership within the territory and region. The ability to establish positive relationships with surgeons, hospital staff, and colleagues will facilitate access to customers and support the provision of data-driven, reliable solutions. Collaboration with team members is essential to effectively support reimbursement and sales activities. The role requires professionals to be team-oriented, highly attentive to detail and flexible to work untraditional hours to best support the salesforce and customers.

Requirements

Bachelor’s degree in relevant field (Public Policy, Health Economics, Business, Science, or Healthcare Administration)
Minimum 3 years of experience in reimbursement, market access, health economics for a medical technology company, healthcare consulting firm, insurance, healthcare delivery system, or physician/hospital/ASC practice management.
Strong ability to communicate medical device benefits to patients, providers, and payers through presentation and training program design.
Demonstrated understanding of US healthcare reimbursement mechanisms and regulations related to medical technology products.
Excellent verbal and written communication skills, including public speaking and presentation
All field sales professionals who are required to gain entry into healthcare facilities to perform the basic remit of their role must successfully complete the credentialing process and comply with the requirements of those facilities they support, which can include adherence to any established vaccine protocols.

Nice To Haves

AAPC certification (CPC, COC, Coding Auditor, etc.) or minimum 3 years of coding, coverage, and payment experience preferred.

Responsibilities

Support the day-to-day reimbursement and market access needs for both internal and external customers.
Implementing and managing Patient Access Programs that build the foundation of market adoption.
Training, education, and oversight of programs.
Use analytical skills to solve reimbursement issues and train customers on billing practices.
Partner with physicians, hospitals, and sales teams to address coding issues and provide reimbursement support, including, but not limited to, assisting customers with understanding escalated cases, benefit verification, prior authorization coordination, payer issue resolution, and ongoing case management to ensure timely access to care.
Develop coverage strategies, particularly for in-office procedures.
Collaborating internally, they'll help implement coding and payment strategies for ENT products.
Educating customers on payer trends
Supporting practices in their reimbursement activities
Escalating payer issues to payers
Assisting in developing educational tools
Reporting on reimbursement initiatives