Sr. Manager, HEMA – Health Policy & Reimbursement

About the role:
The Senior Manager, Health Economics & Market Access (HEMA) will oversee Health Policy & Reimbursement activities in support of our Interventional Cardiology businesses. The Sr. Manager will serve as a subject matter expert regarding US Health policy and payment trends and will work in close collaboration with our corporate HEMA and Government Affairs colleagues to anticipate, monitor, and positively influence payer policies. 
 
Responsibilities:

• Serve as Interventional Cardiology (IC) lead in the review and analysis of annual CMS rulemaking for IPPS, OPPS, ASC and PFS. Collaborate with HEMA Analysts to prepare internal and external communications. Collaborate with the Corporate HEMA team to develop comments in response to topics of importance to IC with strategic guidance from HEMA Directors to positively influence our business.
• Maintain proficiency in current and evolving health policy topics (e.g., VBP, MIPS, MCIT, Telehealth, AI) to inform HEMA strategies and landscape assessments, especially for emerging markets. Serve as a content expert for the IC-HEMA team and the IC liaison to Payer Relations and Global Health Policy team at Corporate.
• Serve as a technical expert for IC-HEMA on cardiovascular coding topics relevant to IC 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.
• Participate in industry coalitions and workgroups (e.g., AdvaMed, MDMA). Communicate relevant updates to IC-HEMA franchise Directors and collaborate with these leaders to define and communicate policy positions.
• Attend CPT panel meetings and the CPT and RBRVS Annual Symposium as a company representative. Proactively identify topics of interest. Collect pertinent information and communicate back to the HEMA team and the businesses as appropriate.
• Coordinate monthly meetings with relevant Professional Societies. Collect topics, communicate agendas in advance and serve as meeting moderator. Document and communicate discussion topics and action items.
• 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 strategies to facilitate global reimbursement and funding, and influence IC Franchise plans. 
• Present complex information to a broad and diverse group of stakeholders. 
• US-focused overnight travel is estimated at 10-15%.

Required qualifications:

• Bachelor’s degree or equivalent, preferably in economics, healthcare administration, health policy, public health, or similar discipline
• 7+ years working in the delivery and/or administration of healthcare or the medical device industry, including cardiovascular experience
• Knowledge of CPT codes, relative value units (RVUs), HCPCS codes, Ambulatory Payment Categories (APCs), ICD-10 codes diagnosis and procedure codes and MS-DRGs
• Interventional Cardiology industry experience
• Experienced and knowledgeable regarding Medicare policies and processes affecting the Physician Fee Schedule (PFS), Outpatient Payment System (OPPS), and Inpatient Payment System (IPPS)
• Understanding of hospital financial systems and management practices
• Computer literacy (Microsoft Office Suite)
• Periodic domestic travel estimated at 10%, including overnight 

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 
• Certified Coder credentials in the cardiovascular space
• Experience in global market access, health policy, and reimbursement