Senior HEMA Manager

About the role:
The Senior Health Economics and Market Access (HEMA) Manager will work in close collaboration with stakeholders in Interventional Cardiology Therapies and Corporate HEMA to lead and execute market access strategy for coronary intravascular lithotripsy (IVL). The Senior HEMA Manager will develop methods to positively advocate and remove barriers to access and to ensure coverage and reimbursement for the division’s emerging technologies and commercially marketed products (e.g. coronary and peripheral lithotripsy).

Successful candidates will have excellent technical expertise in the areas of healthcare administration and delivery, facility and physician reimbursement, and health economic value messaging. Candidates will exhibit outstanding communication skills with the ability to present complex information to a broad and diverse group of key stakeholders and will have the ability to convey the unique capabilities that the Company has in this market. The role is ideal for high performing team leaders who excel at both strategy and execution.

Locations: Boston, MA | Minneapolis/St. Paul, MN | Washington, DC

Responsibilities will include:

• Serve as product portfolio lead in the tracking, review and analysis of annual CMS rulemaking for IPPS, OPPS, ASC and PFS, and track commercial coverage policies.
• Collaborate with HEMA Analysts to prepare internal and external communications and training materials.
• Collaborate with Corporate HEMA team to develop comments in response to topics of importance to the Interventional Cardiology Business, and proactively and strategically engage with national commercial payers to address any private insurance coverage challenges, with strategic guidance from HEMA Directors to positively influence our business.
• Serve as technical expert on cardiovascular coding topics relevant to Interventional Cardiology procedures and services. Provide coding expertise to the IC-HEMA team in support of data analytics initiatives, Health Economics research (incl. Real World Evidence), and market assessments.
• Develop and deliver educational content on health policy, reimbursement, and documentation topics for HEMA colleagues, cross-functional colleagues and sales team representatives. Prepare FAQs related to reimbursement and documentation topics of importance to our customers. Support HEMA Analysts in reviewing customer inquiries and assisting with responses as needed.
• Coordinate with Senior HEMA team members and global HEMA partners to develop market access assessments, health economic and clinical strategy to facilitate global reimbursement and funding, and influence franchise plans.
• Align with and collaborate closely with sales management and teams to educate key hospitals, physicians, other HCPs on product coding, coverage and reimbursement driving acceptance and utilization.
• Track OUS regional reimbursement methods and trends to inform and improve strategic and tactical planning and execution.

• Monitor policy and competitive landscape developments impact the reimbursement of company products and communicate to HEMA team and senior leaders as appropriate.

• Maintain proficiency in current and evolving health policy topics to inform HEMA strategies and landscape assessments, especially for emerging markets.
• Serve as content expert for the divisional HEMA team and the liaison to Payer Relations and Global Health Policy team at Corporate.
• Present complex information to a broad and diverse group of stakeholders.

Required qualifications:

• Bachelor’s degree in economics, healthcare administration, health policy, public health, or similar discipline
• A minimum of 7 years working in the delivery and/or administration of healthcare or the medical device industry, including cardiovascular experience
• Strong understanding and application of principles and concepts in health economics, reimbursement and/or market access and be capable of articulating the current and future market access landscape
• Knowledge of CPT codes, relative value units (RVUs), HCPCS codes, Ambulatory Payment Categories (APCs), and ICD-10 codes diagnosis and procedure codes and MS-DRGs
• Experience in advocating for Medicare reimbursement improvement and private insurance coverage policy improvement
• Ability to present complex health economic information to both large and small influential groups in a way that is both easy to understand, credible, and engages the audience
• Ability to train sales team members both individually and in groups in the use of economic tools such as calculators, presentations, and messaging in a compliant manner
• Strong business acumen, analytical skills and experience working with various internal business partners (especially Sales, Sales Training, Marketing, and Clinical)
• Ability to directly influence business objectives and to work effectively in a matrixed organization
• Knowledge of US health care policy and payment systems, including Medicare and commercial payer device reimbursement in the hospital inpatient, outpatient, ASC and physician office sites of service
• Understanding of hospital financial systems and management practices
• Ability to work well independently as well as collaboratively; self-motivated and disciplined to meet deadlines in the context of competing priorities and projects; lead and work effectively with cross-functional teams
• Proven ability in working with commercial organizations, ensuring timely engagement and customer support of internal and external customers
• Analytical experience utilizing large data sets to draw conclusions about market size, targeting, opportunity assessment
• Computer literacy (Microsoft Office Suite), including high level of competency in Excel and PowerPoint
• Strong track record of self-initiation and influencing cross functional decisions through collaboration

Preferred qualifications:

• An advanced degree such as an MBA, MPH, MHA, MS, MSc in health policy, health economics, healthcare administration, health services research, public health or similar discipline is highly preferred.