Health Economics & Reimbursement Manager

POSITION SUMMARY:

Manage and support the implementation of Health Economics/market access and reimbursement and strategies related to coverage and payment policies for the North American market.

RESPONSIBILITIES:

• Develop and execute global HEOR data and evidence-generation strategies in alignment with the Clinical Development evidence-generation strategy. 
• Design and execute observational and economic research studies using real-world data, including claims, registry, or EMR data, for clinical and/or pre-clinical product portfolio decisions, marketing, regulatory agency submissions, and product reimbursement strategies to drive market access. 
• Provide strategic input on the selection of patient populations, comparators, HEOR and patient-reported outcomes within clinical trials to enable negotiations, reimbursement, and patient access with global payers and regulatory decision-makers. 
• Support the development of cost-effectiveness models and budget impact models by ensuring relevant data points are included and leveraging real-world data for inclusion if needed. 
• Navigate payers’ (e.g., central Medicare, Medicare contractors, and private insurers) coverage and payment processes. 
• Lead the development of market access (coding, coverage, payment) strategies and resources that enhance patient access to technologies including education to internal and external stakeholders on relevant policy and reimbursement-related issues. 
• Develop and execute strategies to establish and enhance relationships with payors, including insurance companies, government agencies, and other third-party payors. 
• Support internal and external stakeholders (e.g., company field team, hospital coding and billing teams) while leveraging knowledge gained through direct interactions and relationships, in order to provide relevant input to coverage and payment conversations. 
• Monitor changes in the external environment (health policy and regulatory) and advise senior leadership on threats and opportunities with proposed action plans. 

QUALIFICATIONS:

• Bachelor's Degree or Equivalent in life sciences, Health Economics, health policy, or related field 
• Minimum 5 years of related experience in medical device, pharmaceuticals, or HEOR consulting 
• Demonstrated understanding of major North American and global healthcare reimbursement systems, market access trends, and payer/financial decision-maker evidence requirements   
• Experience working with external stakeholders and customers (e.g., vendors, payers, hospitals, physicians, etc.), as well as internal cross-functional teams (Medical Affairs, Clinical Research, Marketing, Professional Education, Regulatory Affairs, and Legal) 
• Exceptional at building, growing, sustaining, and leveraging internal and external stakeholder relationships to drive business objectives. 
• Ability to balance strategic thinking with intricate planning and strong tactical execution. 
• Strong business acumen, problem-solving, organizational, analytical, and critical thinking skills 
• Excellent documentation and communication skills 
• Ability to manage competing priorities in a fast-paced, rapidly changing environment. 

SKILLS AND EXPERIENCE:

• Formulates Comprehensive Plans   
• Executes Comprehensive Plans
• Promotes Teamwork
• Drives Innovation and Change
• Optimizes Communication
• Knows the Business            
• Knowledge of FDA regulations for medical technology and medical device marketing

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