Join a diverse team of innovators who bring their worldview, their unique backgrounds, and their individual life experiences to work every day. It’s no accident —we work hard to cultivate a workforce that reflects our patients and partners. We believe it’s the only way to drive healthcare forward and remain a global leader in medical technology and solutions.

Careers That Change Lives

The Regional Payer Consultant for the Coronary, Renal Denervation, Structural Heart, Aortic, and Peripheral Vascular Health Operating Units is responsible for achieving and expanding market access and coverage. Stakeholders including KOLs, Payers, and health systems providing care to patients are the primary audiences for collaboration. Having a working knowledge of the US coding, coverage and payment systems is essential. Additionally, the role will provide internal guidance and customer support to help identify and manage specific payer issues.

This position supports engagement and strategy with Commercial Payers/Managed Care organizations and Medicare Advantage contractors in the United States. The candidate must live near a major airport.

A Day In The Life

Responsibilities may include the following and other duties may be assigned.

• Develops and manages a network key contacts and relationships with policymakers for U.S. Commercial insurers, Medicaid Payers, and local Medicare Contractors;
• Develop tools to accelerate positive U.S. payer coverage particularly among commercial payers. This includes but is not limited to the dissemination and development of model coverage policies, value dossiers, coverage request submissions, and documents to help providers navigate the prior authorization and claim denial process;
• Assists in the analysis and reporting on government and commercial payer policies affecting reimbursement and/or patient access and develops recommendations to address resulting opportunities or challenges;
• Interacts with local physician champions and important stakeholder groups to facilitate effective engagement with payers;
• Partner with strategic internal colleagues for coordination with payer strategy;
• Work with Government Affairs to drive coverage and payment among state Medicaid plans;
• Collaborate with legal, compliance, and other business groups to assure strict adherence to appropriate engagement processes;
• Support and develop internal communications around coverage policy changes.
• To be successful, this role will develop a deep understanding of company products and therapies, health and payment policies and structures, and the types of evidence that are appropriate for supporting business priorities.
• Works with customers/accounts to develop advocacy campaigns that support coverage and payment strategies.
• Expected travel: approximately 50%.

Must Have; Minimum Requirements

• Bachelor’s Degree
• Minimum 10 years of relevant experience working in the healthcare insurance industry sector having experience and in-depth knowledge of coverage and payment process.
• A minimum of 8 years experience as described with an advanced degree
• No relocation assistance will be provided

Nice To Have

• Highly knowledgeable of Medicare and US commercial payers
• Strong understanding of Health Technology Assessment (HTA) process and requirements
• Reside near major airport
• Highly knowledgeable of cardiovascular therapies, particularly coronary, structural heart and peripheral vascular
• Experience working in medical device industry, hospital administration or related health care field.
• Master’s degree (MBA or MHA preferred) or advanced degree in health policy, Nursing, public administration, clinical research or a related discipline
• Skilled and engaging presenter, including executive-level audiences
• Highly effective verbal and written communication skills
• Highly knowledgeable of HCPCS/CPT and ICD-10 coding