|Skills:||•Comprehensive understanding of all aspects of reimbursement (coding,coverage,and payment) including advanced understanding of reimbursement with products under Medical benefits.
|Required Experience:||5 to 7 years
|Preferred Experience:||5 to 7 years
With oversight from the department Director, Healthcare Policy & Reimbursement, this position, along with the Reimbursement Support Specialist, provides information and resources in a professional, compliant, ethical and effective manner to support reimbursement decisions to use ENT products by providing access and reimbursement support. This position will work closely with the Director, Healthcare Policy & Reimbursement, Reimbursement Support Specialist, Field Sales/Regional Sales Managers, Brand Marketing, Director of Communications, and Clinical.
•Work with payers, physician champions, and professional societies to secure adequate reimbursement of Stryker ENT Products.
•Provide in-service training to sales and marketing on the fundamentals of reimbursement for Stryker ENT Products.
•Support the Director, Healthcare Policy & Reimbursement with execution of reimbursement strategies that proactively integrate and align with marketing and sales strategies.
•Provide monthly report recounting significant activities, progress and follow-up needed to assess the reimbursement environment (coverage, coding and payment) for any new products and procedures.
•In conjunction with the sales training department develop and conduct reimbursement training and educational materials for Stryker ENT field sales and as appropriate home office personnel. Works in conjunction with the Reimbursement Support Specialist to develop and present reimbursement training materials for healthcare providers (hospitals, physicians, and ASC’s.).
•Identifies payer opportunities and implements programs to resolve/decrease barriers to entry for Stryker ENT Products.
•Develops and delivers educational workshops on reimbursement to healthcare providers (hospitals, physicians, ASC’s) and field sales team.
•Monitor and oversee the updating of all product reimbursement guidelines (print and reimbursement web site).Maintain Stryker ENT Reimbursement web site to include: reimbursement-news alerts, Medical Coding updates (HCPCS, CPT, ICD10), and news releases from Medicare (CMS).
•The Reimbursement Operations Manager oversees the responsibilities of the Reimbursement Support Specialist and is solely focused on the end-to-end access and reimbursement process at the customer level. In the event of a reimbursement issue, this role will quickly identify, triage and elevate the situation to appropriate internal or external Stryker ENT partners and manage the communication until appropriate resolution. This role will understand payer coverage issues/opportunities at the customer, regional, and national level as well as develop and implement appropriate and compliant strategies that increase access and neutralize barriers to Stryker ENT Products.
•As a subject matter expert in reimbursement, this role will communicate consistently and in a timely fashion current and pertinent field reimbursement information to internal/external customers. This role may also create training and deliver education programs, as appropriate and in compliance, to sales force, physicians, hospitals, billing personnel, and ASC’s.
•Work closely with key customers to understand burdens in the reimbursement process and direct them to appropriate resources to resolve existing issues.
•Understand reimbursement policies across the continuum and educate providers’ office staff, as appropriate.
•Work with Director of Healthcare Policy and Reimbursement to develop strategies to address access and reimbursement needs across the country. Regularly report access and reimbursement activity to the Director, Health Policy & Reimbursement.
•Contribute to the process for developing new concepts and innovative ways to educate and deliver timely and relevant reimbursement educational materials and collaterals and conducting sales/customer trainings as part of formal and informal knowledge sharing forums.
•Bachelor degree in business, health policy, health economics, life sciences or healthcare discipline.
•5-7 + years in healthcare payer/reimbursement environment within the medical device industry .
•Strong understanding of relevant market reimbursement policy
•Ideally 2+ years of experience in the ENT space or other related chronic disease.
•A successful track record in field reimbursement, clinical education or in medical sales/management of products that required significant payer and reimbursement involvement.
•Comprehensive understanding of all aspects of reimbursement (coding, coverage, and payment) including advanced understanding of reimbursement with products under Medical benefits.
•Technical knowledge of healthcare reimbursement from a patient and provider perspective.
•Experience navigating complex accounts with the ability to establish effective relationships through mutual respect and trust in dealing with others.
•Must be comfortable with ambiguity and not having set processes and structures in place.
•Can identify issues quickly and can develop recommendations to resolve in a timely, compliant manner.
•Strong presentation skills. Ability to clearly and succinctly convey his/her ideas to either groups or individuals.
•Strong regional and national Managed Care knowledge.
•Strong organizational and communication skills.
•Understanding of patient privacy laws including HIPAA and similar state laws.
•Advanced understanding of compliance with OIG & regulatory requirements.
Work From Home: Not available
Travel Percentage: 10%
Stryker Corporation is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Stryker is an EO employer – M/F/Veteran/Disability.
Stryker Corporation will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.