About the Role
Title: Field Reimbursement Director – Remote
Location: United States
Work Type: Remote
Time Type: Full time
Job Type: Employee
Job ID: 250802
Category: Clinical/Regulatory
Job Description:
About the Role:
We are looking for a Field Reimbursement Director to join the Health Economics & Reimbursement team. In this role, you will ensure appropriate articulation of reimbursement (coding, coverage, and payment) information as well as economic value for Gore’s medical device portfolio.
This is a remote position, and you can work from home in most locations within the United States.
Responsibilities:
- Work as a field-based member of the Health Economics & Reimbursement team, becoming heavily integrated and linked with Gore’s sales organization as a critical part of an effective institutional selling engine
- Support the sales organization in topics and projects related to Health Economics & Reimbursement, including the appropriate articulation of value to the economic buying influencers within Gore’s target customer set as well as ensuring key customer objectives are clearly communicated back to Gore’s Health Economics & Reimbursement team when needed
- Participate in customer engagements as part of the Provider Solutions Group (Provider Selling Organization, Provider Marketing, Health Economics, Business Operations and Clinical Sales) as an active extension of the Health Economics function
- Work with Gore’s Health Economics and Outcomes Research team to ensure that the approved value propositions, tools, models and other value messages are fully leveraged within assigned customer accounts
- Collaborate with Reimbursement Strategists to ensure adherence to, and understanding of, federal and local reimbursement and healthcare policies
- Analyze and understand basic payer mix (Medicare / Medicaid / Commercial) as well as other relevant factors for target provider institutions, using tools like Truven Market Scan, Definitive Healthcare, etc
- Investigate, analyze, advise, educate, and develop strategies for addressing coding, coverage, and payment constraints placed by third-party payers (including government) on adoption of medical-device products at the individual healthcare provider, or institutional customer level
- Ensure high level of compliance with all federal and local regulations, along with adherence to professional association code of ethics (e.g., AdvaMed)
- Maintain expert level reimbursement knowledge (coding, coverage, payment) for assigned products and therapies
Required Qualifications:
- Bachelor’s Degree
- Minimum of 5 years of experience working directly with customers to remove reimbursement barriers, and/or payers to gain or improve coverage for products reimbursed under the medical benefit
- Prior experience in delivering reimbursement and economic value messaging, clinical evidence dissemination, and tools to support sales and customers
- Demonstrated knowledge and understanding of U.S. healthcare reimbursement mechanisms and regulations related to reimbursement for medical technology products
- Experience working in medical device industry, hospital administration, managed care, or related health care field
- Strong computer skills, particularly Excel (e.g., for basic economic models), PowerPoint (effective story telling/persuasion)
- Excellent communication ability (both written and presentation ability)
- Travel up to 75%
Desired Qualifications:
- Experience in products and services related to the cardiovascular system, including aortic and peripheral technologies
- Advanced degree in Health Economics, Health Policy, Business Management, Nursing, or a related business/ clinical discipline
- Professional and/or hospital coding certification (e.g., AAPC, AHIMA, etc.)