About the role:

This Senior Manager, Payer Relations & Value-Based Offerings is responsible for supporting the Company’s senior level strategic relationships with key local and regional United States (U.S.) health plans, including integrated delivery network (IDN)-owned health plans. The Senior Manager is responsible for securing market access and coverage for targeted company portfolio of products with payers and provider organizations. Develops and executes business plans for payer stakeholders, within defined territory, to positively advocate and remove barriers to access and to ensure coverage and reimbursement for company procedures and devices. Payer stakeholders include commercial private and public payers (Health Plans, Medicaid, Medicare (local), selected complex provider systems and other market influencers. Partners and collaborates with internal and external stakeholders to understand the barriers to access to company technologies.

Responsibilities will include:

• Managing and leading the development and implementation of local and regional payer activities for the company franchises working with divisional staff and key internal and external stakeholders.
• Actively participating in development and execution of practical strategies to secure optimal coverage for company products and procedures.
• Executing strategies and tactics for reimbursement and access within targeted local and regional plans for key technologies.
• Leading implementation of tactical planning activities required to achieve strategic coverage objectives including payer team tools, provider access tools, sales team messaging, etc.
• Identifying key health coverage needs for company platform products, working with divisional counterparts and health economics and outcomes research colleagues to determine actions required.
• Assessing coverage opportunities and challenges facing the division’s emerging technologies and commercially marketed products.
• Working with new product development teams to ensure health economics and reimbursement needs are incorporated into product development plans and timelines; ensure all necessary new product development deliverables are completed on time and on budget.
• Managing provision of coverage support to sales force and key external stakeholders (e.g., hospitals, clinicians, investigator sites, professional societies) as appropriate.
• Collaborating with the leader of national Payer Relations and Corporate Accounts team to leverage partnership discussions whenever possible to support coverage activities and to share contacts and best practices.
• Monitoring policy developments that impact the coverage of company products.
• Supporting development of direct reports, if any.

Required qualifications:

• A bachelor’s degree (B.A. or B.S.) is required; advanced degree is preferred.
• At least 10 years of payer relations and reimbursement experience within a relevant industry (e.g. diagnostics, managed care, medical device, etc.).
• Deep knowledge of healthcare, marketing, managed care strategy, pricing and the medical reimbursement environment required.
• Prior strategic account management responsibilities or equivalent relationship development or consulting experience with one of the following: payers, government agencies, IDNs, Accountable Care Organizations (ACOs).
• Proven ability to successfully interact with the C-suite.
• Platform presentation skills that make this individual a desired speaker at industry events in front of large groups.
• Proven track record of influence management within a matrix environment.
• Proven ability of successfully managing complexity, solving problems, and building strong relationships.
• 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.
• Ability to maintain and effectively deal with highly confidential matters.
• Proven ability in working with commercial organizations, ensuring timely engagement and customer support of internal and external customers.
• Computer literacy (Microsoft Office Suite), including high level of competency in Excel.

Preferred qualifications:

• Knowledge of Salesforce.com, or a similar Customer Relationship Management (CRM) platform, and other business programs.
• Highly organized with ability to effectively manage multiple priorities in a fast-paced environment.
• Must be able to travel (~15-20%) as dictated by business needs.
• Strong written and oral communication skills.
• Well-developed analytical and strategic skills.
• Ability to model and live the corporate values.