Director of Reimbursment

Position Summary

Responsible for all aspects of reimbursement including development and execution of strategic reimbursement and health economics plans to gain market access and drive sales of Globus Medical products. Effectively monitor and communicate coding, coverage, and payment issues of relevance to all stake holders.

Essential Functions

• As part of Management Team, work collaboratively with Senior Management, Regulatory Affairs, Product Development, Clinical Research, Business Development, Sales, and Marketing to align reimbursement strategy with objectives of company.
• Develop and maintain relationships with key stake holders including surgeon KOLs, providers, and payers.
• Demonstrated ability to work with organizational decision makers, including medical directors, hospital administrators, C-level management, etc.
• Reimbursement support for national sales teams for all product lines.
• Manage GREAT (Globus Reimbursement Education & Assistance Team) Program to provide reimbursement support to surgeons, hospitals, and patients.
• Provide support and assistance to physicians, facilities and their support staff in the reimbursement process
• Provide necessary support to overcome barriers to coverage and reimbursement
• Appeals assistance for patients and customers
• Provide tactical tools including Reimbursement Guides and Quick Reference Guides to assist surgeons and hospitals obtain appropriate and consistent reimbursement for Globus Medical products.
• Monitor and communicate reimbursement changes
• Research reimbursement trends, coverage issues, and payment methodologies
• Apprise sales force and management team of any/all initiatives that may impact reimbursement
• Provide reimbursement in-service training to sales force and training team
• Conduct reimbursement presentations to stakeholders.
• Lead Patient Access Team and Market Access Team

Qualifications

• Demonstrated knowledge and experience in Medicare, Medicaid, and private payer policies, reimbursement process and the health care legislative environment
• Experience with new technology reimbursement
• Knowledge of managed care and/or insurance industry
• Knowledge of payment methodologies
• Knowledge of CPT, HCPCS, and ICD-10 coding systems
• Excellent written and verbal communication skills
• 4 year degree in public health, nursing, healthcare economics, business administration, healthcare administration or related fields or equivalent experience
• 5 plus years of medical device reimbursement experience is highly desirable