Director Reimbursement & Market Access in Virtual, Minnesota at Stryker Corporation

Date Posted: 10/25/2018

Job Snapshot

Job Description

" Founded in 2006, Entellus Medical delivers innovative, high quality, minimally invasive therapeutic solutions to healthcare providers and their patients who suffer from sinusitis.  What makes Entellus Medical great?  Our employees and the great products we offer.   It’s a great time to join our organization.  We are in the process of uniting with Stryker and Spirox.  Leveraging the unique competencies of our three strong organizations to better serve the industry will continue to set us apart from the competition.  This type of growth enables us to truly address our customer’s needs and will help to position us as the market leader in the ENT space. Together, with our customers, we are driven to make healthcare better.  Join us…you have the opportunity to make significant impact with us! Director, Reimbursement & Market Access Position Summary: Build and manage Team Reimbursement to ensure compliant support of business objectives.  Direct global strategic reimbursement planning, economic data creation, health policy and corporate reimbursement strategies and initiatives to obtain positive health plan coverage decisions for the company’s products, including but not limited to: clinical data and publication requirements, health economics, and value proposition models for payor negotiations.  Secure market access, coverage, positive policy and reimbursement, and identify and deliver innovative solutions for Entellus and Spirox products, procedures and technologies in partnership with payors and key provider systems. Responsibilities: Department Leadership • Build global function and build a high-performing team to leverage processes, tools and people where appropriate. • Organize and direct the work of the reimbursement team. Global Reimbursement Planning and Strategy • Maximize global reimbursement for Entellus in a timely manner enabling commercial execution in the US and OUS. • Lead and manage Entellus/Spirox strategies and response to major CMS coverage and payment rules. • Develop and execute global reimbursement policy strategies in support of business strategy and commercialization objectives. • Develop and advocate policy positions on payment for technology in areas of payment policy of interest to Entellus and Spirox. • Build and strengthen the company’s ability to maximize product success during all phases of the product life cycle. • Develop private payor strategies and partnerships to advance Entellus treatment and sales objectives. • Advise senior leadership on the implications of country government and private payor payment policies and legislative changes that may impact access to Entellus products in the pre- and post-market approval environment. • Lead the reimbursement assessment process for new products, including the development of healthcare economic evidence as part of the development and clinical efficacy process. • Identify priority health policy issues and develop policy solutions to advance medical technology and our therapies specifically. • Develop and implement reimbursement strategies to obtain coverage, coding and payment for Entellus products and therapies from national payors, including large private insurers, managed care organizations, government intermediaries and CMS. • Identify payor opportunities to resolve/decrease barriers to entry/adoption for the company’s products and therapies. • Design, conduct, and analyze economic research studies, such as cost-effectiveness, cost/benefit, and cost utility.   • Evaluate the economic impact of the use of our therapies, as well as competing therapies, on payors, including the government. Healthcare Economics • Evaluate the economic impact of the use of our products and therapies on hospitals, ambulatory surgery centers, and physicians. • Design and implement programs to resolve/decrease economic barriers for use of Entellus products and therapies in all care settings. • Work with payors, physician champions, and professional societies to secure appropriate coverage, coding and payment policies for our products and technologies. • Establish and execute payer and provider focused communications regarding the value of Entellus products. • Research reimbursement trends, coverage issues, and payment methodologies. Payor and Customer Relationships:  • Maintain relationships with third party payors. • Provide advocacy and coalition work. • Serve as the principal spokesperson with Medicare and other payors on issues critical to the mission of the business. • Maintain relationships with senior CMS personnel and ensure appropriate Entellus representation at significant Entellus meetings with CMS. • Work with customers/accounts to develop advocacy campaigns that support coverage and payment strategies. • Develop, maintain and create access to key relationships with government payor, private payor, trade industry and medical society decision-makers as it relates to payment policy, coverage, and coding. • Provide support and assistance to physicians, facilities and their support staff in the reimbursement process. Policies and Training • Develop and deliver reimbursement education programs for Entellus customers and field sales force. • Implement policy and payment changes with our field sales force and customers through education and services. • Develop marketing programs, materials and training related to coverage, coding and reimbursement. • Provide training and education programs for internal and external audiences.   Society and Trade Industry Activities: • Collaborate with AAO and support society guidelines to accelerate market access to Entellus and Spirox products. • Represent the company in various trade industry activities as required. • Serve as liaison to specialty, patient and professional societies on all product-specific reimbursement related matters. Other Reimbursement:  • Create global strategic reimbursement plans. • Provide input into clinical data creation. • Provide reimbursement-related advice to product development teams, marketing, regulatory, clinical and sales. • Establish and leverage relationships with key payor stakeholders and Key Experts to develop advocacy for Entellus products. • Work collaboratively with industry colleagues and appropriate trade and professional associations to ensure appropriate coverage, coding and payment of medical technology products. • Perform economic data creation. • Work closely with both internal and external stakeholders to develop and deploy access and reimbursement solutions that address mutually aligned priorities and brings value to all parties;  • Deliver and create clear and concise communications and presentations using approaches that highlight the most pertinent information for internal and external stakeholders and spur stakeholder actions.  , Qualifications: • Bachelor’s degree required. • 8 – 10 years of Healthcare payment policy and reimbursement industry experience. Preferably with a medical device company. • Knowledge and experience working with private (Health Plans/Employers) and/or public payors (Medicaid/Medicare) in policy, access and reimbursement issues required. • Knowledge of the various payment methodologies, CPT and HCPCS coding systems. • Knowledge of managed care and/or insurance industry. • Experience presenting clinical and economic evidence and tools required. • Experience working in the Medical Device, Employer sponsored health benefits, and/or healthcare marketing arena preferred. • Demonstrated ability to work with organizational decision makers, including medical directors, hospital administrators, billing specialists, business / physician office managers, etc. • Experience supporting commercial execution and enabling accelerated sales. • Strong leadership skills, including the ability to set goals and provide positive and constructive feedback respectfully to build positive relationships and improve business results. • Demonstrated ability to build and lead high performance teams including recruiting, talent development and performance management. • Ability to work effectively within a team in a fast-paced changing environment. • Strong verbal and written communications with ability to effectively communicate at multiple levels in the organization. • Multi-task, prioritize and meet deadlines in timely manner. • Strong organizational, planning, and follow-up skills and ability to hold others accountable. • Up to 30%-40% overnight travel may be required. • Valid U.S. driver’s license with clear driving record required. "

Work From Home: No

Travel Percentage: None

Stryker Corporation is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Stryker is an EO employer – M/F/Veteran/Disability.

Stryker Corporation will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

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