The Senior Strategic Reimbursement Manager will serve in an impactful role developing and implementing reimbursement strategic goals and establishing operational plans for assigned Cardiac Rhythm and Heart Failure (CRHF) Businesses. This role will ensure the successful execution of reimbursement and health policy strategies in the US; provide input and support global reimbursement strategies supporting both pipeline and new market opportunities within the CRHF Business units.
This role will provide an early analysis of US evidence requirements, articulation of the current US reimbursement landscape and strategic path forward for successful reimbursement at launch and beyond. This role will collaborate with HEOR and market access colleagues to access the US landscape and opportunities in a fee for service and Value Based Health Care (VBHC) payment model to support and establish optimal US reimbursement opportunities. Additionally, this role will support the development of economic value strategies supporting new product development within the CRHF Business units.
This role will partner closely with regional reimbursement colleagues to develop the global reimbursement strategy (e.g. identify and leverage global reimbursement synergies and support execution of country specific reimbursement plans that address payers needs, e.g. HTA support). Based on the global reimbursement landscape this role will provide input in the planning of new products and designing of the studies to ensure US and global payer, governmental, societal and other critical partners and stakeholder requirements are met.
This role is accountable for informing and educating CRHF leadership, Business Units, Strategy Teams and Field Teams such as the Market Access team of the coding, coverage and payment strategies and execution.
A Day In The Life
Lead the process for developing and executing US specific reimbursement strategies based on the requirements of payers, including Medicare, commercial payers and US technology assessment organizations, etc.
Integrate requirements of major global payers by articulating their evidence requirements into the product development processes
Work with CRHF Business Units to evaluate the reimbursement opportunities and barriers for business development products and services and provide strategic product-specific support to the businesses and HEOR and market access teams in the areas of US reimbursement strategy and health policy.
Partner with HEOR and Market Access Teams to engage and keep the teams informed of reimbursement assessments, strategies and executional progress with therapies, products and new indications.
Have a comprehensive knowledge of the requirements (including clinical and cost) of CMS, as well as major commercial payers.
Participate, as necessary, as a member of the core or extended global product development teams to provide input on all aspects of US reimbursement and health policy.
Ensure appropriate Reimbursement and Health Policy analyses and perspectives are integrated into business plans.
Be a key point of contact supporting and driving reimbursement activities with professional societies, lobbyists, other organizations.
Lead, as a functional subject matter expert and spokesperson, briefings with internal and external contacts including Vice Presidents of Marketing, Legal, R&D, Clinical, Corporate and Global reimbursement counterparts to support and educate on reimbursement requirements.
Provide CRHF Senior Leadership team with regular updates as well as strategies to address changes in the U.S. Medicare payment system.
Manage, secure and maintain knowledge of U.S. health care systems and changes in reimbursement environments tracking developments in the government, private payer and health care environment as it relates and influences Medtronic’s current and future product and indications portfolio.
Ensure timely surveillance and in collaboration with BU, lead and/ or provide technical expertise in the opportunity and communication of robust responses to AHRQ, National, local or private policies and other health care related rule changes.
Work in collaboration with legal, quality and other business groups support process and management of CRHF Field actions.
Support preparation and manage dedicated annual operating budget to support reimbursement and health policy requirements and actions.
Facilitate meetings with health care professionals and reimbursement and economic consultants as required to support strategic development and tactical implementation.
Ability to travel up to 25%
Must Have; Minimum Requirements
Bachelor’s degree in health policy, public policy, sciences or related field of study.
A minimum of 10 years of relevant experience in Medical Device industry
Demonstrated knowledge of Medicare, health insurance policies, and payer/provider procedures.
Understanding of and experience with reimbursement systems in major European and Asian countries
Proven knowledge and execution of US coverage, coding and payment strategy and tactics.
Works independently and demonstrates an ownership in work; acting under little direction towards predetermined long-range goals and objectives.
Proficient knowledge in word processing, spreadsheets, and/or database applications (e.g. MS Word and Excel).
Nice to Have
Advanced degree in health policy, health services research, economics, or related discipline.
Understanding of global dynamic health care environment
Demonstrated ability to work with key US stakeholders – societies, CMS, private payers, political groups, etc.
Ability to maintain proactive relationship with payers, providers, and government agencies
Demonstrated use of business and financial measures and the impact on reimbursement issue resolution.
Demonstrated ability to understand and educate customers on the impact of reimbursement requirements and pathways and the need to develop practical solutions.
Strong project management skills and excellent track record in effective collaboration in the matrix environment
Excellent communication and presentation skills -- written and verbal.
Certified professional coder.
Together, we can change healthcare worldwide. At Medtronic, we push the limits of what technology, therapies and services can do to help alleviate pain, restore health and extend life. We challenge ourselves and each other to make tomorrow better than yesterday. It is what makes this an exciting and rewarding place to be.
We want to accelerate and advance our ability to create meaningful innovations - but we will only succeed with the right people on our team. Let’s work together to address universal healthcare needs and improve patients’ lives. Help us shape the future.
Physical Job Requirements
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position.
The physical demands described within the Day in the Life section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Telecommuting is allowed.
Internal Number: 18000L67
Making healthcare better is our priority, and we believe medical technology can play an even greater role in improving
people’s lives. With challenges facing families and healthcare systems — such as rising costs, aging populations, and
the burden of chronic disease — we are harnessing the power of technology to take healthcare Further, Together.
Innovation and collaboration are central to who we are. Since the late 1940s, we have been working with others to
alleviate pain, restore health, and extend life. Today, we are a medical technology leader offering therapies and solutions
that enable greater efficiency, access, and value — for healthcare systems, providers, and the people they serve.