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Senior Reimbursement and Health Policy Analyst Job in Mounds View, Minnesota

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Job Title: Senior Reimbursement and Health Policy Analyst

Required Certifications:CPC
Required Experience:3 to 4 years
Preferred Experience:3 to 4 years
Location: Mounds View 55112, MN, US
Date Posted:1/9/2020
The Senior Reimbursement and Health Policy Analyst will support the day to day reimbursement needs for CRHF commercialized products and therapies.  The Senior Reimbursement and Health Policy Analyst is experienced in the area of government reimbursement policies and third party reimbursement, particularly as it relates to supporting hospital and physician customers. The role contributes regularly to developing and distributing materials and information and educating key reimbursement and health policy information to internal and external customers. 
In this role, you will serve as a key partner to the Regional Economic Managers on the day to day reimbursement and health policy for commercialized products. You will be a partner with HEOR colleagues, Regional Economic Managers, and external customers on the reimbursement and related regulations on commercially released products.  

A Day In The Life
  • Serve as point of contact for incoming questions from Regional Economic Managers, sales team members and external customers via the RS mailbox.
  • Update and maintain current coding, coverage, payment information and tools that supports customer understanding and education.
  • Leads the process to provide therapy and product-specific support and analysis to the field in the areas of US reimbursement rules and regulations for commercially released products in CRHF. Maintain a comprehensive knowledge of the rules and regulations of CMS as well as major commercial payers.
  • Perform environmental scanning for a well-defined set of topics pertinent to CRHF diseases, therapies and diagnostic investments and potential future ventures to identify competitive products, environmental changes or trends to support field and BU reimbursement intelligence and strategic and tactical planning. 
  • Contribute to solutions to reimbursement coding, payment and coverage challenges for commercialized products.  
  • Partner with other team members and the US Regional Economic Managers on critical coding, coverage and payment hospital focused messages and development of tools and customer resources. 
  • Contribute to the process for developing new concepts and innovative ways to educate and deliver timely and relevant reimbursement education materials and collaterals and conducting web based training as part of formal and informal knowledge sharing forums.
  • Contribute to reimbursement education programs to internal and external constituents facilitating knowledge transfer and independence through understanding. These programs can include training, best practice sharing, and delivery and sharing of reimbursement expertise and knowledge.
  • Serve as the point of contact and bring experience in supporting clinical trial agreement negotiations and in determination of standard of care and protocol induced procedures.
  • Contribute to and project manage cross-functional projects such as Web Ex and education management, Medtronic apps and coverage policy management.

Must Have; Minimum Requirements
  • Bachelors of Science or Bachelor of Arts Degree 
  • Minimum four (4) plus years of healthcare work experience in reimbursement for a medical technology/device company, health care consulting firm, insurance company, healthcare delivery system or medical society.
  • One or more of the following coding credentials: RHIA, CCS, CCS-P, CPC or CIRCC

Nice To Have 
  • Proven work experience in providing coding, coverage, and payment advice in a healthcare setting with an emphasis on cardiology. 
  • Demonstrated knowledge and understanding of U.S. healthcare reimbursement mechanisms (Medicare prospective payment systems, third-party payer coverage, clinical and procedural coding) and regulations related to medical technology products. 
  • Working knowledge of federal regulations pertaining to Medicare rules and coverage policies for cardiac devices.
  • Solid working knowledge of clinical trial policy coverage and understanding of clinical procedures and clinical study design.
  • Able to make recommendations and implement process improvement opportunities. 
  • Able to work independently, cross functionally and as part of a team to problem solve and seek advice when necessary performing work with limited oversight and supervision. 
  • Able to manage multiple tasks with high degree of organization-prioritization skill and attention to detail and accuracy.
  • Excellent verbal and written communication skills.
  • Customer service focused.


To apply, copy and past the link into your browser:  http://m.rfer.us/MEDpSO15nS 

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