Director Reimbursement and Payer Relations - Medical Device Start-up Company

Novasys Medical has an excellent opportunity for you to take your career to the next level by leading and implementing both strategic and tactical reimbursement activities within Novasys Medical in the areas of coding, coverage and payment.  You will be working with, and reporting directly to, the Vice President, Marketing and Reimbursement. The role involves interaction with payers, physicians, and physician office staff as well as various groups within Novasys Medical, including Sales, Marketing, and Clinical.

 

Novasys Medical is a company dedicated to improving the quality of life for women and has developed a new treatment for stress urinary incontinence, a disorder that affects over 8 million women in the United States alone. Novasys Medical has received FDA clearance and is currently launching products that provide a simple outpatient, non-surgical approach to urologists, urogynecologists and gynecologists to treat their patients.  For more information on the company:  www.novasysmedical.com

 

Major Duties and Responsibilities: Develop overall payer strategy and communicate strategy, goals and progress to management team and sales force on a regular basis. Review and adjust payer targets as environment changes and gain agreement on changing priorities. Payer relations:  will have overall responsibility for getting coverage decisions:  establish and implement action plans with each targeted assigned payer, and monitor/supervise Reimbursement Manager payer relations efforts. Proactively seek out payer presentation opportunities. Coordinate and direct physician advocacy efforts, gaining sales’ input to help identify appropriate physician advocates. Develop payer presentation materials (clinical data) with CMO. With management team, develop and implement coding strategy. Manage and lead Reimbursement Department: identify department needs, hire and train new employees and outside resources as needed, assess and deploy resources as needed for payer efforts and customer claim support.  Update reimbursement material as needed and ensure that current publications and appropriate attachments are utilized by physician practices/facilities and the sales force for claims submissions and appeals. Identify needs for additional customer, payer and sales force materials and develop new materials as necessary. Directly supervise Reimbursement Manager, Reimbursement Specialists, outside customer support group, and other consultants as required. Provide appropriate training of sales representatives and other internal groups as needed on reimbursement strategies and activities. Collaborate and communicate regularly with VP of Sales to provide appropriate direction and support to sales team. Identify and recommend additional resources needed (either in-house or external) to support reimbursement initiatives – whether customer or payer focused. Travel as necessary with sales representatives, VP of Sales, and/or Chief Medical Officer; attend sales meetings and training classes, tradeshows, etc.

 

Educational and Experience Requirements: College degree with minimum 7-10 years experience in reimbursement activities with a medical device company, with significant experience in establishing coverage policies with both local Medicare carriers and large and small commercial payers.

 

Other Qualifications: A strong understanding of medical device reimbursement coding, coverage and payment processes and practices. Experience in gaining payer coverage decisions and development of coverage policy. High level of interpersonal skills: influencing, resolving conflict, and creative problem solving.  Must be an excellent communicator using all available channels. Ability to make effective presentations to all levels of company management, physician practice staff, and payers. Strong organizational skills, ability to prioritize and complete projects. Experience with health plan and provider billing functions. Ability to think strategically. Strong customer focus. Ability to travel (job requires 25 – 30% travel).