Manager, Market Access and Reimbursement - East (remote)

Arthrex, Inc.•Naples, FL

63d•Remote

About The Position

Arthrex is a global medical device company and leader in orthopedics medical education. With a corporate mission of Helping Surgeons Treat Their Patients Better, Arthrex has pioneered the field of arthroscopy and develops more than 1,000 innovative products and procedures each year that support all aspects of orthopedics. Arthrex is actively searching for a Manager of Market Access and Reimbursement. The successful candidate will work alongside a department of expert orthopedic healthcare professionals, world class faculty, and product management. Main Objective: The Manager, Market Access and Reimbursement will support the Market Access and Reimbursement department to achieve its mission to connect patients, providers, and payors and ensure patients can access our best-in-class technologies and products. They will serve as the primary reimbursement expert supporting the field in all areas related to reimbursement of Arthrex products and assist the Director, Market Access and Reimbursement on execution of company strategies related to field reimbursement initiatives, including HCP engagement, support, and communication. This role will work alongside the Sales, Product Management, and Strategic Development teams to improve patient access for our best-in-class technologies and products.

Requirements

5+ years of experience working in the delivery and/or administration of healthcare, healthcare insurance plan or the medical device industry required
Bachelor's degree required.
Detailed knowledge of medical device billing, coding (e.g., CPT, HCPCS, ICD-10, APC, DRG).
Detailed knowledge of payer coverage requirements, Prior Authorization, claim submission, adjudication, and appeals processes.
Knowledge of U.S. health care policy, payment systems and contracting methodologies, including Medicare and commercial payers, in inpatient and outpatient, physician office, and ASC/HOPD sites of service.
Ability to train sales team members both individually and in groups regarding coding, coverage, reimbursement, and contracting concepts in a way that is easy to understand, credible, and engages the audience.
Demonstrated responsiveness and sense of urgency when pursuing goals and completing tasks. Demonstrated ability to set and manage priorities, while managing multiple projects.
Ability to work with ambiguity and continuously adapt in a rapidly changing atmosphere.
Experience working as part of both functional and cross-functional teams.
High customer service orientation with outstanding people skills, including developing relationships at all levels in an organization and directly inï¬uencing business objectives.
Ability to effectively prioritize and implement multiple workstreams in a dynamic environment of multiple stakeholder audiences.
Ability to work independently and eï¬ectively with minimal supervision.
Demonstrated skills in account management and customer service, including use of CRM (e.g., Salesforce).
Computer literacy (remote connectivity, Microsoft Oï¬ce Suite).
Must have a valid driver's license with a clean motor vehicle record.
Must be able to travel throughout the U.S. via plane, train, or vehicle.
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Ability to comprehend and apply mathematical principles to the degree required to perform the job based upon job requirements.

Nice To Haves

Master's Degree or other advanced degree is a plus
Experience in Orthopedic medical devices desired but not required.
Prior field reimbursement experience in medical devices desired but not required.
Certified Professional Coder (CPC) credential or willing to obtain within 1 year of hire date.

Responsibilities

Manage special projects (e.g., internal hotline, Chatter) and corresponding activities with accountabilities for successful completion.
Educate and train Arthrex' Sales team and respective agencies, as assigned, on all aspects of U.S. reimbursement (coding, coverage, payment, and contracting) for the product portfolio and messaging in-person, virtual meetings and on-demand phone calls.
Develop, manage, and deliver reimbursement educational programs for Arthrex internal (sales reps. & sales leadership) and external (surgeons, hospitals, ASCs, payers) customers.
Collaborate with Marketing, Sales, Product Management and Regulatory teams to anticipate market needs and inform the development of customer-facing tools, economic models, and other tactical elements of reimbursement to maximize patient access to Arthrex's technologies and products.
Work in partnership with Sales and Sales leadership to plan and prioritize key customer visits, virtual and in-person, to provide education, and deliver value-based messages to drive patient access.
Develop and implement reimbursement, market access, and value-based strategies to promote broader access for patients, in alignment with commercial objectives.
Develop and support relationships with local physician champions to support interactions with payors.
Monitor and research reimbursement trends, market changes, coverage issues, coding developments, payment methodologies and communicate recommendations.
Triage and manage routine internal and external requests.
Travel up to 40%.
Ensure compliance within functional areas and support the compliance objectives of the organization as a whole.