Senior Manager, Operations & Market Access

Intuitive•Sunnyvale, CA

About The Position

The Reimbursement Operations & Field Market Access lead is the execution engine of the U.S. HEMA organization and the primary tactical interface with providers, payers, sales, and marketing. The role is both payer-facing and provider-facing. It develops value dossiers, manages payer advisory boards, supports key-account engagement, creates billing guides and provider education materials, responds to customer reimbursement questions, and manages field logistics for coding implementation. Initially, the role handles both midstream and downstream responsibilities, from code acquisition and payment-policy implementation to field collateral and customer support. It shares midstream and payment-policy work with the Upstream Strategist until a dedicated midstream hire is made, anticipated in approximately 18 months. Thereafter, the role shifts to a downstream focus, with outsourced or in-sourced field pull-through teams supporting product launches. The position also manages reimbursement vendors and field resources, tracks payer coverage policies and payment changes, and develops compliant reimbursement tools and operational guidance for sales teams and provider accounts. Intuitive notes that proof of vaccination against certain diseases may be required depending on the role or customer. The position may be filled at a different job level depending on business need and the selected candidate’s qualifications. Compensation is market-competitive and includes base pay, incentives, benefits, and equity; the posting says target compensation ranges are listed but provides no figures in the supplied text.

Requirements

Four-year degree.
At least 6 years of progressive experience in medical device or pharmaceutical reimbursement, field market access, or payer relations.
Direct experience developing billing guides, coding tip sheets, and provider reimbursement education materials.
Strong working knowledge of CPT, HCPCS, and ICD-10 coding systems and hospital billing workflows, including OPPS, ASC, and physician office workflows.
Experience managing payer relationships, developing value dossiers, and executing advisory boards.
Demonstrated ability to work closely with sales and marketing teams in a commercial support capacity.
Strong project management skills and ability to manage multiple simultaneous deliverables across products.

Nice To Haves

Certified Professional Coder (CPC) certification is strongly preferred.
Experience managing field reimbursement teams, outsourced or in-house.
Familiarity with FCA/AKS compliance requirements for manufacturer-provided reimbursement guidance.
Experience with business intelligence platforms.

Responsibilities

Create, maintain, and distribute comprehensive billing and coding guides for all products; ensure they are CPC-reviewed, compliance-approved, and updated with each code cycle.
Serve as the primary point of contact for management of customer reimbursement vendor(s), manage vendors, monitor performance, and retain required documentation.
Manage field logistics for implementation of new or existing CPT, HCPCS, and ICD-10 codes; coordinate with provider sites to support coding adoption and cost capture.
Generate evidence-driven, compliant field collateral in support of sales and marketing.
Coordinate with Upstream to develop and distribute value dossiers and payer-facing evidence packages communicating the clinical and economic value of the product portfolio.
Manage fractional headcount resources and coordinate payer engagement at key accounts.
Track payer coverage policies, MAC LCDs, and commercial payer guidelines, translating upstream payment-policy developments into actionable field tools and communications.
Manage and direct field personnel for payer-focused campaigns, coordinating field reimbursement specialists, outsourced resources, and account-level teams to execute engagement strategies, coverage initiatives, and pull-through programs.
Support CPT/HCPCS code acquisition with the Upstream Strategist, including preparing materials for AMA and CMS submissions.
Translate CMS OPPS/PFS payment-policy changes into field guidance and develop communications for code changes, payment updates, and coverage determinations.
Develop and maintain compliance-accurate reimbursement estimation tools for sales teams and provider accounts.
Field customer questions regarding reimbursement and develop provider education materials.