The Cardiac Management Solutions division of ZOLL Medical Corporation develops products to protect and manage cardiac patients, including the LifeVest® wearable cardioverter defibrillator (WCD), the ZOLL cardiac monitor, and associated technologies.
Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. To date, the LifeVest WCD has been worn by hundreds of thousands of patients and saved thousands of lives.
ZOLL has been Pittsburgh’s Manufacturer of the Year, one of Western PA’s Healthiest Employers, and even one of Pittsburgh’s Coolest Offices. But it’s our unique opportunity to impact people’s lives that makes ZOLL the ideal place to build your career.
Position Summary: The Director, Payer Programs and Innovation will have responsibility for building ZOLL’s strategic direction associated with alternative payment models; including employer, labor, value-based, bundled payment, and other risk sharing arrangements. The Director will develop partnerships with internal and external stakeholders to deliver programs that improve patient outcomes .
Essential Duties and Responsibilities:
- Serve as a market access innovation expert across the ZOLL portfolio
- Develop partnerships with healthcare systems, payers and third parties to deliver value based programs and initiatives to improve patient outcomes
- Lead employer and labor engagement programs to produce case by case authorizations
- Manage employer and labor relationships to build advocacy for the WCD
- Deliver programs that positively impact physician and patient engagement with the WCD
- Identify and implement programs to navigate payer’s WCD utilization management challenges
- Work with state Medicaid programs to improve fee schedule methodology
- Identify and build solutions for access challenges throughout ZOLL’s external stakeholders
- Evaluate pricing and reimbursement trends to maintain a current and forward look of environment changes and their implications for the ZOLL portfolio
- Partner with the IDN Director, CDx Director and National Account lead to integrate alternative payment model solutions into ZOLL’s program offerings
- Play a lead role in educating other internal partners and stakeholders on evolutions and trends regarding payer practices for pricing, reimbursement, legislation and regulations, etc. across key markets
- Work closely with other Directors in execution of National Account’s team business plan
- Performs other duties as assigned by Management.
Supervisory Responsibilities: May have supervisor responsibility
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.
Educations and/or Experience:
- Bachelor's degree required, Master's degree preferred.
- 7-10 years related experience or equivalent combination of education and experience.
- Track Record of influencing medical policy decisions
- Attention to detail in execution of multi-faceted National Accounts strategies
- Demonstrated initiative in implementing innovative strategies in improving target accounts
- A documented track record of sales success within the medical device industry.
- Strong insurance industry background within multiple facets of the payer market.
- Fluency in insurance and medical terminology.
- Demonstrated leadership and change management skills.
- Track record of delivering results within a large organization through a collaborative style.
- Demonstrated ability to develop and execute strategic sales plans for insurance providers.
- Highly developed organizational and planning skills.
- Knowledgeable in the reimbursement and appeals processes, and regarding medical policy.
- Excellent oral and written communication skills and the ability to present and articulate effectively to individuals on all levels.
- Experience as a national account manager or equivalent position within an insurance company.
Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Mathematical Skills: Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.
Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 25 pounds.
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- The noise level in the work environment is usually quiet.