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At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at https://www.jnj.com/ .
Johnson & Johnson is looking for an Associate Director, US Payment and Reimbursement to join our US Value and Access Health Economics Market Access (HEMA) team supporting DePuy Synthes, our orthopedic medical technology business! This is an exciting opportunity to shape payment strategy and development of reimbursement materials, associated value messaging, and communication tools in support of Business Unit platform objectives and customers as they seek to grow their orthopedic service lines. This position will be located in either Palm Beach Gardens, FL; West Chester, PA or Raynham, MA
The position requires knowledge and experience with U.S. healthcare costs and affordability, coverage, coding & Reimbursement of medical technology, health insurance coverage and benefit design including Medicaid, the ACA and Medicare, payment and delivery system reform, value assessment or value-based care (VBC), and understanding of social determinants of health, including the regulation of emerging and digital technologies.
Responsibilities:
- Works closely together with Government Affairs & Policy to track and analyze Centers for Medicare & Medicaid Services (CMS) rule proposals and other policy matters, particularly as they relate to Medicare coverage, coding, and payment of medical technology used in all site of care settings, by physicians and other practitioners in the services they provide patients, or through the provision of diagnostic tests.
- Engage directly with payers as needed to establish coverage, coding, and reimbursement policies in accordance with market access strategy and business plans.
- Establish subject matter expertise to routinely provide CMS and commercial payment, reimbursement, coding and coverage materials to key business partners within targeted platforms.
- Contribute to the creation of training for surgeons, providers, internal teams, and field sales related to the economic value of DePuy Synthes technologies in a compliant manner.
- Support reimbursement training efforts for surgeons and relevant administrators as necessary.
- Provides support to US colleagues for reimbursement and coding systems, and/or private health insurance design.
- Collaborate on generating reimbursement or VBC propositions in Orthopedic medical technology. Develop associated materials, tools, and messaging to support external and internal stakeholders.
- Day-to-day support of customers and field-based sales teams on reimbursement matters.
- Troubleshoot with internal and external stakeholders as needed to address reimbursement needs.
- Identify opportunities for the development of collateral to support educational and economic value messaging efforts for customer presentations.
Qualifications
- A minimum of a bachelor's degree required; An advanced degree, MBA/MPH/MHS/MA/MS with health policy or economic focus is preferred.
- A minimum of 5 or more years' experience with establishing, enhancing, and/or communicating reimbursement and economic information required
- Experience establishing, enhancing, and/or communicating reimbursement and economic information for surgical procedures is preferred
- Extensive knowledge in U.S. healthcare coverage, coding, and reimbursement policy, including Medicare, Medicaid, and private insurance required
- Knowledge of the US Healthcare Provider landscape in the context of coverage, coding and reimbursement.
- Experience with medical technology and implantable products preferred
- US reimbursement experience working with both private and public payers required
- Experience providing compliant reimbursement support for commercial teams and providers is required
- Experience communicating an economic value story for surgical procedures/products to healthcare customers preferred
- Demonstrated ability to collaborate with and support field-based sales personnel in account development is preferred
- Excellent oral communication, written communication, and presentation skills is required
Johnson & Johnson is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
