Manager, Market Access and Reimbursement - North Central
Arthrex
Summary
The Manager, Market Access and Reimbursement will support the Market Access and Reimbursement department to achieve its mission to connect patients, providers, and payors and ensure patients can access our best-in-class technologies and products. They will serve as the primary reimbursement expert supporting the field in all areas related to reimbursement of Arthrex products and assist the Director, Market Access and Reimbursement on execution of company strategies related to field reimbursement initiatives, including HCP engagement, support and communication. This role will work alongside the Sales, Product Management, and Strategic Development teams to improve patient access for our best-in-class technologies and products.
Job description
Essential Duties and Responsibilities
- Educate and train Arthrex' Sales team and its respective agencies on all aspects of US reimbursement (coding, coverage, payment, and contracting) for the product portfolio and messaging in-person, virtual meetings and on-demand phone calls.
- Collaborate with Marketing, Sales, Product Management and Regulatory teams to anticipate market needs and inform the development of customer-facing tools, economic models and other tactical elements of reimbursement to maximize patient access to Arthrex's technologies and products.
- Work in partnership with Sales and Sales leadership to plan and prioritize key customer visits, virtual and ultimately in-person, to provide education, and deliver value-based messages to drive patient access.
- Develop and implement reimbursement, market access, and value-based strategies to promote broader access for patients, in alignment with commercial objectives.
- Develop and support relationships with local physician champions to support interactions with payers and intermediaries.
- Travel up to 40%.
- Ensure compliance within functional area and support the compliance objectives of the organization as a whole.
Education and Experience
- 5+ year(s) of experience working in the delivery and/or administration of healthcare, healthcare insurance plan or the medical device industry required
- Bachelor's degree required. Master's Degree or other advanced degree is a plus
Knowledge and Skill Requirements/Specialized Courses and/or Training
- Experience in Orthopedic medical device desired, but not required
- Prior field reimbursement experience in medical device desired, but not required
- Certified Professional Coder is a plus
- Detailed knowledge of medical device billing, coding (e.g., CPT, HCPCS, ICD-10)
- Detailed knowledge of payer coverage requirements, Prior Authorization, claim submission, adjudication and appeals processes
- Knowledge of US health care policy, payment systems and contracting methodologies, including Medicare and commercial payers, in inpatient and outpatient, physician office and ASC/HOPD sites of service
- Ability to train sales team members both individually and in groups regarding coding, coverage, reimbursement and contracting concepts in a way that is easy to understand, credible, and engages the audience
- Demonstrated responsiveness and sense of urgency when pursuing goals and completing tasks.
- Demonstrated ability to set and manage priorities, while managing multiple projects
- Ability to work with ambiguity and continuously adapt in a rapidly changing atmosphere
- Experience working as part of both functional and cross-functional teams
- High customer service orientation with outstanding interpersonal skills including developing relationships at all levels in an organization and directly influencing business objectives
- Ability to effectively prioritize and implement multiple workstreams in a dynamic environment of multiple stakeholder audiences
- Ability to work independently and effectively with minimal supervision
- Demonstrated skills in account management and customer service, including use of CRM (e.g., Salesforce)
- Computer literacy (remote connectivity, Microsoft Office Suite)
- Must have a valid driver's license with a clean motor vehicle record
- Must be able to travel throughout the U.S. via plane, train or vehicle
Machine, Tools, and/or Equipment Skills
Experience working with a variety of software tools including Microsoft Office Suite and industry leading Analytics and Business Intelligence software.
Requirements
- 5+ years of experience in healthcare, healthcare insurance plan, or medical device industry
- Bachelor's degree
- Detailed knowledge of medical device billing, coding (CPT, HCPCS, ICD-10)
- Knowledge of payer coverage requirements, Prior Authorization, claim submission, adjudication and appeals processes
- Knowledge of US health care policy, payment systems and contracting methodologies, including Medicare and commercial payers
- Ability to train sales team members on coding, coverage, reimbursement and contracting concepts
- Demonstrated ability to set and manage priorities and manage multiple projects
- Experience working as part of functional and cross-functional teams
- High customer service orientation with outstanding interpersonal skills
- Ability to work independently with minimal supervision
- Demonstrated skills in account management and customer service, including CRM (e.g., Salesforce)
- Computer literacy (remote connectivity, Microsoft Office Suite)
- Valid driver's license with a clean motor vehicle record
- Ability to travel up to 40% throughout the U.S.
Benefits
- Medical, Dental & Vision Insurance
- Company-Provided Life Insurance
- Voluntary Life Insurance
- Flexible Spending Account (FSA)
- Supplemental Insurance Plans
- Matching 401(k) Retirement Plan
- Annual Bonus
- Wellness Incentive Program
- Gym Reimbursement Program
- Tuition Reimbursement Program
- Trip of a Lifetime
- Paid Parental Leave
- Paid Time Off
- Volunteer PTO
- Employee Assistance Provider (EAP)
- Long Term Incentive Program
Company overview
Arthrex is a global leader in orthopedic medical device innovation and minimally invasive surgical technology. Founded in 1981 and headquartered in Naples, Florida, the company has pioneered the field of arthroscopy and maintains a strong focus on advancing orthopedic surgical procedures worldwide. With the corporate mission of "Helping Surgeons Treat Their Patients Better," Arthrex develops over 1,000 innovative products and surgical procedures annually, specializing in arthroscopy, sports medicine, total joint arthroplasty, and orthobiologics. As a privately held company with a family business culture, Arthrex operates globally with regional offices in Munich, Mexico City, and Singapore, serving healthcare professionals across more than 31 locations. The company is renowned for its comprehensive medical education programs, state-of-the-art manufacturing facilities, and commitment to delivering uncompromising quality in orthopedic care. Arthrex continues to experience significant growth while maintaining its dedication to scientific research, product development, and supporting surgeons in improving patient outcomes through minimally invasive techniques.