Director of Reimbursement Strategy - Medical Device
San Diego, CA (hybrid; on-site 3x a week)
I am partnered with a large pharmaceutical company specializing in chronic pain management. They are looking for a strategic leader to develop their reimbursement strategy for their medical device division. In this role, you will partner cross-functionally with Clinical, Field Market Access, and other internal departments to ensure alignment on reimbursement strategy.
Key Responsibilities
- Collaborate with internal and external partners to effectively package and position existing evidence and data.
- Identify clinical and evidence gaps related to emerging coverage requirements.
- Partner with clinical and medical colleagues to ensure evidence generation activities align with market access and reimbursement goals
- Clearly communicate the medical device value message to payers.
- Understand and recommend changes to current reimbursement methodologies.
- Identify and address obstacles related to coding, coverage, and reimbursement.
- Collect voice of customer (VOC) feedback to understand real-world impact.
- Identify opportunities to collaborate with and educate payers.
- Manage relationships with key influencers and payer networks.
- Collaborate with marketing on product value propositions and outcomes.
- Develop and oversee reimbursement tools and support programs.
- Serve as a resource for HEMA/HEOR material development and communication.
- Work with internal partners on messaging and resources for patient access.
- Partner with field teams to gather insights on market dynamics and execute tactics for market access
- Be the go-to resource for medical device reimbursement within the organization.
Qualifications:
- Bachelor's Degree: Required; Health Policy, Finance, Business, or related field a plus.
- Minimum of 8 years of health-care related experience required.
- Minimum of 5 years of Reimbursement & Market Access experience required.
- Experience in bringing medical device coverage from strategy development to execution and value creation.
- Current and relevant working relationships with executive-level decision makers at payers, societies, associations, and coalitions.
- In-depth understanding of key payer processes and medical policies.
- Demonstrated understanding of CMS and commercial payment models and trends.
- Knowledge of medical billing, coding, appeals, denials, and single case/procedure rates.
- Willingness to travel 50%+
