Boston Scientific HEMA Manager - CRMDx Downstream 

United States, Minnesota 

850256325

The manager will provide downstream commercialization support related to market access to our field sales organization and work with any field reimbursement resources to address coding, coverage, payment, and economic questions that arise about CRMDx technologies. The manager will be responsible for developing reimbursement and market access training materials and tools to be used in the field. The manager will also support upstream strategic efforts topositively advocate and remove barriers to access and to ensure coverage, coding, and reimbursement of the division’s emerging technologies and commercially marketed products.

Your responsibilities will include:

• Support the field sales organization and any deployed field reimbursement resources with regards to market access questions associated with the commercialization of key CRMDx technologies.
• Develop reimbursement and market access training materials and tools to be used with sales and customers to address the reimbursement and economic elements associated with CRMDx technologies.
• Liaise with payer relations team members to support efforts to secure coverage or overturn non-coverage for new CRMDx technologies.
• Serve as the main point of contact for the third-party call center supporting prior authorization and appeals efforts by customers.
• Support the CRMDx HEMA lead in the review and analysis of annual CMS rulemaking for IPPS, OPPS, ASC and PFS and the development of internal and external communications.
• Serve as a technical expert for CRMDx HEMA on cardiovascular coding topics relevant to CRMDx procedures and services. Provide coding expertise to the CRMDx 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.
• Review customer reimbursement and market access inquiries and provide responses as needed.
• Align with and collaborate closely with sales management and teams to educate hospitals, physicians, and other HCPs on product coding, coverage and reimbursement, driving acceptance and utilization.
• Track regional reimbursement methods and trends to inform and improve strategic and tactical planning and execution.
• Support the development of coding applications as well as applications for differential payment including but not limited to New Technology Add-On Payments (NTAPs), Transitional Pass-Through (TPT) Payments.
• Present complex market access information to a broad and diverse group of stakeholders in a simple and concise way that facilitates learning, acceptance, and execution.

Required qualifications:

• Bachelor’s degree in economics, healthcare administration, health policy, public health, or similar discipline
• 5+ 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
• 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

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 appreciated

Compensation fornon-exempt (hourly), non-sales rolesmay also include variable compensation from time to time (e.g., any overtime and shift differential) and annual bonus target (subject to plan eligibility and other requirements).

Compensation forexempt, non-sales rolesmay also include variable compensation, i.e., annual bonus target and long-term incentives (subject to plan eligibility and other requirements).

For MA positions:It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.