Sr. Director, Reimbursement and Market Access (Remote US)
Teleflex

Job Info

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Expected Travel: More than 50%

Requisition ID: 8513

About Teleflex Incorporated

Teleflex is a global provider of clinically effective medical technologies designed to improve the health and quality of people's lives. We apply purpose driven innovation - a relentless pursuit of identifying unmet clinical needs - to benefit patients and healthcare providers. Our portfolio is diverse, with solutions in the fields of vascular and interventional access, interventional cardiology, surgical, anesthesia, cardiac care, interventional urology, urology, emergency medicine and respiratory care. Teleflex employees worldwide are united in the understanding that what we do every day makes a difference. For more information, please visit teleflex.com.

Interventional Urology - NeoTract is dedicated to developing innovative, minimally invasive and clinically effective devices that address unmet needs in the field of urology. As part of the Teleflex Interventional Urology business unit, NeoTract's focus is on improving the standard of care for patients with benign prostatic hyperplasia (BPH) using the UroLift® System, a minimally invasive, permanent implant system that treats symptoms while preserving sexual function*1,2. The UroLift System is clinically proven to treat lower urinary tract symptoms due to BPH in men over the age of 45. The UroLift System lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. More than 400,000 men have been treated with the UroLift System in select markets worldwide.** Join a dynamic, growing team that offers healthcare providers an array of medical technology solutions that make a difference in patients' lives.

* No instances of new, sustained erectile or ejaculatory dysfunction in the FDA pivotal study.

** Management estimate based on product sales and average units per procedure

Roehrborn, J Urology 2013 LIFT Study

McVary, J Sex Med 2014

Indicated for the treatment of symptoms of an enlarged prostate up to 100cc in men 45 years or older. As with any medical procedure, individual results may vary. Most common side effects are temporary and include pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate and/or the inability to control the urge.1 Rare side effects, including bleeding and infection, may lead to a serious outcome and may require intervention. Speak with your doctor to determine if you may be a candidate.

Position Summary

The Senior Director, Strategic Reimbursement and Market Access is a highly visible position that carries strategic responsibility as well as tactical implementation to support US Sales and other cross-functional commercialization teams within the Interventional Urology (IU) Business Unit and the broader Teleflex organization. This position is responsible for hiring, onboarding and managing direct report(s), including but not limited to field-based Healthcare Policy, Reimbursement Education and Training, and Reimbursement Access Specialists. Serves as the field expert in coding, coverage, and payment related to the IU, and potential Teleflex, products for the purpose of facilitating broad ease of patient access to care. This position requires experience supporting field-based reimbursement teams, will support the national development and execution of reimbursement strategy to create a favorable reimbursement climate for Teleflex products, and facilitate US Sales reimbursement education and training, and requires excellent communication skills, and the ability to perform at high levels in a fast-paced, dynamic environment.

Principal Responsibilities

• Identify, develop & execute on key reimbursement strategies for current products/products in development
• Identify & actualize opportunities to obtain favorable coding, coverage & payment decisions and health technology assessments (HTA)
• Orchestrate KOL & Teleflex presentations to all levels of decision makers including CMS, Medical Directors, HTA Committees or others
• Develop and maintain professional relationships with Carrier Advisory Workgroup (CAG) members, KOLs, and state/regional/national professional societies to support reimbursement efforts
• Maintain a comprehensive understanding of local/regional/national reimbursement coverage issues through research of payer websites, face-to-face meetings, KOL interviews & attendance at public meetings
• Research & analyze payer policies and reimbursement as they relate to Teleflex and competitive products
• Provide comprehensive reimbursement support to Teleflex customers by identifying key areas and/or accounts that could benefit from a deeper reimbursement education
• Individually and through direct reports and the sales organization, identify trends in internal/external customer reimbursement challenges, develop proactive solutions through educational opportunities and training, including, but not limited to, new customer onboarding, input into Sales Quarterly Reviews, zone and/or customer specific retraining as needed
• Lead & develop direct reports with the goal of providing highly effective and highly efficient reimbursement support to both internal and external customers; develop as needed internal team flow charts to insure team efficiencies
• Facilitate & approve the Healthcare Policy and Access Education Team's quarterly & annual goals
• Collaborate with the VP of Reimbursement, and other team members, to develop the broader Reimbursement Team's annual goals
• Collaborate with the VP of Reimbursement to create annual & forecasted sub-budgets specific to the Healthcare Policy & Access Education Team's needs/expected activities
• Create standardized but modular, compliant education materials that can be customized for regional specificity as well as adapted to specific customer needs
• Support the creation & distribution of compliant educational reimbursement tools for both internal & external use
• Collaborate cross-functionally to ensure appropriate coding, coverage and payment information is utilized in the execution of cross-functional objectives. Direct responsibility for precise cross-functional external reimbursement communication & utilization of current reimbursement tools
• Prepare and participate in the delivery of reimbursement education and updates to all levels of select internal customers; including, but not limited to, executive & sales meetings, national sales meetings, & Teleflex corporate meetings
• Develop and execute on strategies to improve the customer's perception & experience as it relates to coding, coverage and payment for Teleflex products
• Provide reimbursement expertise cross-functionally as requested by the Executive Team, Sales Leadership & Reimbursement team
• Facilitate the identification of KOLs, and others, from the company's customer base that may be good candidates to support Teleflex coverage and/or coding initiatives
• Monitor, maintain, and potentially grow the Healthcare Policy & Access Education team in direct relationship to company and Sales needs and expansion

Education / Experience Requirements

• Minimum of BA/BS degree in Business, Economics, Basic Sciences or similar alternative.
• Minimum of 10 years medical device reimbursement experience, including coding, coverage, and payment experience.
• Minimum of 2 years of leadership experience; management of direct reports, required.
• Ability to identify, hire, onboard/train and lead direct report(s).
• Previous experience supporting internal (sales; strategic accounts; management team, etc.) and external customers (physician offices, ASCs, hospital outpatient personnel, etc.)
• Proven track record educating internal and external customers for the purpose of minimizing and/or eliminating coding, coverage and payment obstacles
• Prior sales and/or customer service experience preferred
• Government Affairs and trade association experience preferred
• Urology experience is a plus

Specialized Skills / Other Requirements

• Strong understanding of private and government reimbursement policy including coverage development
• Knowledge of Medicare, Medicaid and Private Insurer reimbursement methodology
• Understanding of healthcare benefits (deductible, out of pocket, benefit exclusions, etc.).
• CPC accreditation preferred
• Solid understanding of CPT, ICD-10, HCPCS, and POS coding
• Understand and use root cause analysis to correctly identify reimbursement issues.
• Experience working with legal and compliance functions to support communication from reimbursement to internal and external customers.
• Ability to work with outside consultants to solve reimbursement issues arising from CMS rules, including MPFS and HOPPS.
• Understand and explain the unintended consequences of strategic solutions offered from outside the leadership of the reimbursement department.
• Ability to understand and defend operational changes within the department using budgetary, ROI, and KPI logic.
• Understanding of HIPAA compliance.
• Effective negotiation skills with internal customers as needed
• Capable of in-depth analysis and problem resolution
• High attention to detail and strong organizational and follow up skills
• Strong working proficiency in Microsoft Office, including Word, Excel, PowerPoint and Outlook
• Ability to work independently
• Comfort with delegating responsibilities as appropriate
• Ability and desire to successfully interact with all levels of management and healthcare professionals including medical office staff, physicians, policy analysts, medical directors and CMS.
• Strong interpersonal communication (written and verbal) and presentation skills
• Ability to work within the constraints of a regulated industry while achieving objectives
• Ability to identify priorities, meet deadlines, and work effectively in a fluid, fast-paced environment
• Ability to develop and foster relationships with team members and key business stakeholders
• Pro-active and results oriented
• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Ability to analyze financial information including the interpretation of RAs/EOBs.
• Demonstrated analytical skills. Ability to read, understand and abide by company procedures. Ability to define problems, collect data, establish facts, draw valid conclusions and report on findings. Skilled at interpreting coding, remittance advice/explanation of benefits, and denials.
• Support the Reimbursement Team's efforts to analyze payer policies and reimbursement related to Teleflex's current/future products, as well as competitive products
• Support the Executive Team, Sales Leadership & the Reimbursement team to develop & maintain reports as requested, including, but not limited to, progress and tracking reports
• Contribute to the Teleflex culture of being collaborative, respectful, transparent, ethical, efficient, high-achieving, and fun!
• Ability and willingness to travel approximately 60% of the time both domestic and international. Overnight travel will be required.

Position is based remote in the US, with a preference to be based near a major airport.

Teleflex, Inc. is an affirmative action & equal opportunity employer. D/V/M/F. Applicants will be considered without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality, sex, or veteran status. If you require accommodation to apply for a position, please contact us at: 262-439-1894.

Teleflex is the home of Arrow®, Deknatel®, Hudson RCI®, LMA®, Pilling®, Rüsch®, UroLift® and Weck® - trusted brands united by a common sense of purpose. Teleflex, the Teleflex logo, Arrow, Deknatel, Hudson RCI, LMA, Pilling, Rüsch, UroLift and Weck are trademarks or registered trademarks of Teleflex Incorporated or its affiliates, in the U.S. and/or other countries.

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