Health Economic Manager
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Job Description
Health Economic Manager partnering with sales teams and providers to drive reimbursement for Medtronic ENT therapies. Leading complex projects as a reimbursement and healthcare economics expert.
Responsibilities:
- Provide input and assist in developing reimbursement materials and tools for customers (Physicians, Coding Staff, Administrators, etc.) and the field sales team.
- Identify educational needs of priority accounts and use approved Medtronic tools to deliver relevant training and education on coding, billing, and reimbursement.
- Develop a monthly report of provider activities, including regional trends and developments, to support quarterly updates to Senior Leadership.
- Develop and implement reimbursement strategies and tactics aligned with Sales leadership to minimize or remove coding, coverage, and payment barriers for Medtronic products and therapies.
- Serve as the primary field-based expert for reimbursement, coding, and coverage.
- Educate administrators, billing managers, and healthcare providers on correct use of HCPCS, CPT, ICD-10 codes, modifiers, and documentation requirements.
- Support customers in navigating Medicare, Medicaid, and commercial payer coverage policies and prior-authorization requirements.
- Provide one-on-one and group training on prior authorization, claim submission, appeals, and payment processes.
- Identify, triage, and resolve access barriers in collaboration with internal reimbursement support teams.
- Identify key issues and trends with commercial and government payers; determine and implement appropriate solutions.
- Conduct webinars for new and existing customers (frequency based on customer need) and track/report attendance.
- Partner with sales, marketing, and clinical teams to ensure a seamless customer experience and compliance.
- Deliver in-person and virtual reimbursement workshops and policy update sessions.
- Collaborate with Sales, Marketing, Medical Affairs, and Compliance teams.
- Provide field insights on reimbursement trends and economic models as warranted.
- Work with Marketing colleagues on strategies addressing the needs of key Government, Healthcare Agencies, and Commercial Stakeholders, influencing economic and policy decisions on product coding and reimbursement.
- Participate in initiatives supporting new product launches and payment advocacy efforts.
- Ensure compliance with corporate and regulatory requirements.
Requirements:
- Bachelor’s degree required.
- Minimum of 7 years of relevant experience, or an advanced degree with a minimum of 5 years of relevant experience with medical device coding, coverage, and payment (reimbursement).
- Work experience directly related to the payer or healthcare provider decision makers (C-suite, administration, director –level) physicians, private practice managers.
- Experience developing and implementing strategic relationships and concepts with key influencers, utilizing business and financial measures with economic modeling.
- Experience creating and giving presentations.
- Experience utilizing effective influencing and sales skills.
- Knowledge and/or experience negotiating payer/provider contracts.
- Experience building strong cross-functional partners.
- For Baccalaureate degrees earned outside of the United States, a degree that satisfies the requirements of 8 C.F.R. § 214.2(h)(4)(iii)(A) is required.
Benefits:
- Health, Dental and vision insurance
- Health Savings Account
- Healthcare Flexible Spending Account
- Life insurance
- Long-term disability leave
- Dependent daycare spending account
- Tuition assistance/reimbursement
- Simple Steps (global well-being program)
- Incentive plans
- 401(k) plan plus employer contribution and match
- Short-term disability
- Paid time off
- Paid holidays
- Employee Stock Purchase Plan
- Employee Assistance Program
- Non-qualified Retirement Plan Supplement (subject to IRS earning minimums)
- Capital Accumulation Plan (available to Vice Presidents and above, or subject to IRS earning minimums)
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