Leader, Reimbursement and Market Access

NuVasive   •  

San Diego, CA

Industry: Medical Equipment


8 - 10 years

Posted 374 days ago

Job Description

Job Summary

This role supports the EVP External Affairs in overseeing and building the reimbursement function for NuVasive, maximizing payer access to NuVasive’s commercial products, facilitating payer understanding of value of NuVasive solutions and working cross-functionally and with key stakeholders to ensure coverage, reimbursement and access to NuVasive solutions. Must demonstrate a comprehensive knowledge of reimbursement rules and processes, and be able to advise senior leadership succinctly on the impact of various coding, coverage and commercial and government reimbursement policies. Must devise and execute reimbursement and market access strategies. Requires experience in various complex reimbursement areas including Medicare and Medicaid, commercial payer policies and processes, medical device and services coding and coverage issues, and can demonstrate relationships with payers and key stakeholders.

Essential Functions

  • Lead development and execution of coding, coverage and reimbursement strategies.
  • Develop trusted relationships with commercial and government payers, and key stakeholders.
  • Manage reimbursement considerations in new product pipeline, potential acquisitions, and current company divisions. 
  • Manage reimbursement consultants and hotlines and ensure smooth and rapid response and issue resolution to incoming inquiries.
  • Respond to, interpret and translate coding, coverage and reimbursement issues, translate impact to business, devise strategies to address and advocate for advantageous coding, coverage and reimbursement positions for NuVasive product and services.
  • Ensure a highly compliant reimbursement culture and enhance enterprise capacity on reimbursement and coverage issues, as well as payer relationships.
  • Work cross functionally across multiple divisions, including clinical research, regulatory, sales, corporate development, and product development to devise and execute strategies.
  • Must have an understanding of complex Medicare/Medicaid reimbursement, experience with device and/or life science, and experience with commercial payers.
  • Ability to model various reimbursement scenarios and opportunities and potential impact.
  • Lead the development of market shaping opportunities through evolving customer and government models.
  • Educate commercial and sales leads about changes in reimbursement.
  • Collaborate with commercial partners to assess the payer needs landscape and propose strategic and organizational capabilities to secure access for NuVasive products.
  • Assist in the development and execution of high impact messaging that convey the value proposition of NuVasive solutions.
  • Monitor competitive activities and devise strategies to adapt to changing environment.
  • Over time, build out capacity to do more strategic reimbursement work in value based and new payment models, build out economic capabilities to validate NuVasive value proposition for payers and providers.

Basic Qualifications

  • Bachelors Degreerequired
  • Minimum 7-10 years prefer medical device reimbursement.
  • Must thrive working in a fast-paced, innovative environment while remaining flexible, proactive, resourceful and efficient.
  • Excellent interpersonal skills, ability to develop important relationships with key stakeholders and payers, good conflict management and negotiation skills, ability to analyze complex issues to develop relevant and realistic plans, programs and recommendations.
  • Must be a strong communicator and be able to portray confidence and capability when calling on payers to influence coverage decisions.
  • Demonstrated ability to translate strategy into action; excellent analytical skills and an ability to communicate complex issues in a simple way and to orchestrate plans to resolve issues and mitigate risks.
  • Willingness to travel (approximately 20%).

Preferred Qualifications

  • Masters Degree.
  • 10+ Years of experience in medical device reimbursement.
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