Director, Reimbursement – Market Access
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Job Description
Director of Reimbursement & Market Access at PolyNovo leading strategic reimbursement and health economics efforts. Ensuring timely patient access to innovative medical technologies in the U.S.
Responsibilities:
- Lead the strategic development and execution of reimbursement and health economics (HEOR) strategies for PolyNovo’s portfolio
- Ensure that patients have timely access to NovoSorb technology by securing favorable coverage policies
- Navigate the complexities of hospital value analysis committees (VACs), Medicare/Medicaid, and private payers
- Develop and execute comprehensive market access launch plans for new products and line extensions
- Monitor and influence coding, coverage, and payment policies (DRGs, CPT codes, HCPCS) relevant to dermal substitutes and synthetic skin grafts
- Lead the development of the "Value Dossier" to articulate PolyNovo’s economic and clinical advantages over traditional biological scaffolds
- Engage directly with key medical directors at national and regional payers to secure positive medical policy coverage
- Support the field sales team by providing tools and messaging to navigate Hospital Value Analysis Committees (VACs)
- Address reimbursement barriers by providing education to billing and coding departments
- Collaborate with the Clinical Affairs team to identify gaps in data and develop "Real World Evidence" (RWE) that demonstrates long-term cost savings (e.g., reduced length of stay, fewer surgeries)
- Manage the creation of budget impact models and cost-effectiveness analyses
- Represent PolyNovo in industry trade associations (e.g., AdvaMed)
Requirements:
- Bachelor’s degree in Life Sciences, Economics, or Business
- MPH, MBA, or PharmD preferred
- 8+ years in Medical Device Market Access or Reimbursement
- Experience in Wound Care, Trauma, or Aesthetics is a significant plus
- Deep understanding of US coding (CPT, ICD-10, HCPCS) and the OPPS/IPPS payment systems
- Ability to travel up to 30-40% for payer meetings and site visits
- Existing relationships with CMS or major private payers (UnitedHealth, Aetna, etc.) are highly valued
- Ability to communicate the value of synthetic materials in a market historically dominated by biologics
Benefits:
- Total compensation package consisting of base salary, bonus, and incentive plans
- 401k plan with company match
- Comprehensive medical, dental, and vision insurance for employees and their families
- Generous paid time off, 12 company holidays, and two paid Nurture days per year
- Parental leave for primary and secondary caregivers
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