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Director of Market Access, Reimbursement and Medical Policy - Alpharetta Georgia
Company: Avanos Medical Location: Alpharetta, Georgia
Posted On: 04/23/2024
Requisition ID:5847 Job Title:Director of Market Access, Reimbursement and Medical Policy Job Country:United States (US) Here at Avanos Medical, we passionately believe in three things: Making a difference in our products, services and offers, never ceasing to fight for groundbreaking solutions in everything we do; Making a difference in how we work and collaborate, constantly nurturing our nimble culture of innovation; Having an impact on the healthcare challenges we all face, and the lives of people and communities around the world. At Avanos you will find an environment that strives to be independent and different, one that supports and inspires you to excel and to help change what medical devices can deliver, now and in the future. The Avanos COVID-19 Vaccine Policy: This Policy applies to U.S. customer-facing / field-based employees & Avanos leadership: All U.S. customer-facing / field-based employees hires must be fully vaccinated against COVID-19. Proof of being fully vaccinated does not need to be disclosed until a job offer has been made but must be submitted within 48 hours after the acceptance of the job offer. If you have a qualifying medical condition or sincerely held religious belief or practice that precludes you from receiving a COVID-19 vaccine, you may apply for an exemption or deferral after you accept the job offer and before your scheduled start date. The reasonable accommodation provided to the employee, if any, will depend on the employee's job and the applicable facts, but it may include weekly COVID-19 testing and masking requirements. New hires who do not submit, before their scheduled start date, proof of being fully vaccinated or a request for a reasonable accommodation will have their job offer revoked. Avanos is a medical device company focused on delivering clinically superior breakthrough solutions that will help patients get back to the things that matter.We are committed to creating the next generation of innovative healthcare solutions which will address our most important healthcare needs, such as reducing the use of opioids while helping patients move from surgery to recovery. Headquartered in Alpharetta, Georgia, we develop, manufacture and market recognized brands in more than 90 countries. Avanos Medical is traded on the New York Stock Exchange under the ticker symbol AVNS. For more information, visit . Department Health Economics and Reimbursement Position Director of Market Access, Reimbursement and Medical Policy Job Position Purpose / Summary Customer facing role responsible for assisting in the execution of health economic and reimbursement strategies of Avanos' interventional pain management products. Key functions to include coding and payment analysis, insurance authorization, coverage and cost effectiveness analysis as well as collaborating/building relationships with internal and external customers. Location Remote, Hybrid or Onsite Purpose of the Position: Creates strategies to obtain/optimize payment and coverage from third-party payers, CMS/other government payers, and healthcare customers for Avanos Medical's product portfolio including MIC-KEY, ON-Q, AMBIT and Interventional pain (IVP) management products [TRIDENT and COOLIEF cooled radiofrequency technology]. Manages the national Market Access, Reimbursement, and Health Policy teams. Leads efforts to directly market payment/reimbursement opportunities and market access value propositions with payers, providers and value analysis committees to drive sales growth. Develop critical relationships with physicians and payers to drive appropriate clinical utilization on medically necessary patients and, therefore, sales of IVP product/s. Responsibilities (fundamental job duties): - Manages the national Market Access Reimbursement and Health Policy teams.
- Recruits, develops, leads the performance of employee(s) to develop the program aligned with market access , reimbursement and health policy.
- Leads the market access /reimbursement and health policy teams in developing and regularly updating reimbursement and health policy tools for use with sales, physicians, facilities and payers.
- Sets goals which align to Avanos' organizational plans and manages the execution of goals through mentoring.
- Develop the Avanos national payer strategy to market the value proposition of products directly to payers to secure favorable product reimbursement.
- Leads efforts to directly market payment/reimbursement opportunities and healthcare economic value propositions with payers, providers and value analysis committees to drive sales growth.
- Provide strategic expertise to sales and marketing to develop and implement plans to achieve sales/revenue objectives.
- Develop critical relationships with physicians and payers to adopt clinical utilization of IVP (TRIDENT & COOLIEF), AMBIT, ON-Q and MIC-KEY products
- Builds and formulates collaborative relationships with Avanos functional departments and serve as a liaison to external stakeholders.
- Drive facility and provider network development by providing market access, reimbursement and medical policy expertise to executive teams of health care systems, hospitals, independent, joint-venture and ASC management companies.
- Mentor professional education and sales teams to properly educate customers on the benefits of Avanos products on appropriate medically necessary patients.
- Influence appropriate government agencies and health care payers to obtain appropriate coverage and payment.
- Interact with the American Medical Association and CMS to obtain coding and coverage for new modalities/procedures and product codes
- Provide expertise on state and federal regulations for reimbursement methodologies and appropriate coding for IVP products.
- Manages and directs the monitoring of third-party resources and data that may be utilized to drive the creation of analyses.
- Monitors, interprets, and summarizes changes in the external environment (regulatory/reimbursement changes, managed care arrangements, etc.) produces internal communication strategies on threats and opportunities with suggested action plans to IVP products.
- Is the internal and external subject matter expert on market access, reimbursement and medical policy matters related to Interventional Pain products.
- Complies with U.S. Food and Drug Administration (FDA) regulations, other regulatory requirements, company policies, operating procedures, processes, and task assignments.
- Maintains positive and cooperative communications and collaboration with all levels of Avanos employees, customers, contractors, and vendors.
- Performs other related duties and responsibilities as requested
Reporting Relationships: Direct report the Vice President of Strategy and Marketing Positions reporting to this job include: |
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