Director, Market Access & Reimbursement - Alpharetta, GA or Remote

Director, Market Access & Reimbursement - Alpharetta, GA or Remote

Requisition ID:7245

Job Title:Director, Market Access & Reimbursement - Alpharetta, GA or Remote

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.

Employment for customer facing roles is contingent upon your ability to satisfy all vendor credentialing requirements. If you are unable to be credentialed, Avanos reserves the right to withdraw your employment offer or end your employment. If you require a medical or religious accommodation from these requirements or if you would like to understand more about these requirements, please advise HR so that we can provide additional information and if needed, we can explore any needed accommodation(s).

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. For more information, visit

Essential Duties and Responsibilities

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.

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.

Key Responsibilities

• 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.

• 1 Reimbursement Operations Manager
• 2 Reimbursement Patient Access Specialist
• 1 Field Director of Payor Engagement

External Interface

Health Insurers, both government and commercial , third party billing companies, current and potential customers, Industry Trade Associations, KOLs, professional medical societies, CMS, and US governmental agencies

Internal Interface

All business groups within the organization

20-40% travel. Prefer relocation to Alpharetta GA although not required.

Your qualifications

Required

• Bachelor’s degree required, MBA desirable.
• 10+ years of medical device reimbursement, third party billing experience, strategic marketing experience.
• Medical device industry experience required.
• Successful performance in this position requires a broad-based knowledge in medical device market access, reimbursement, patient access, payer coverage policy, employee management, business management, project management, marketing, and extensive experience in general health care.
• Strong communication, interpersonal, and analytical skills.
• Excellent leadership qualities.
• Persuasive, self-driven and motivated.
• Strong analytical and presentation skills, innovative and resourceful.
• Ability to communicate effectively, both written and orally.
• Proficient in use of Microsoft PowerPoint, Excel, Windows and Microsoft Office.
• Experience with data visualization software (e.g., Tableau) and CRM applications (e.g., Salesforce.com), or aptitude to learn such tools.
• General ability to learn and acclimate to new systems.

Preferred

• Demonstrated clinical acumen through interface with various physicians.
• Ability to drive appropriate payment coverage of IVP products by payers.

The statements above are intended to describe the general nature and level of work performed by employees assigned to this classification. Statements are not intended to be construed as an exhaustive list of all duties, responsibilities and skills required for this position.

Salary Range

The anticipated average base pay range for this position is $180,000.00 - $230,000.00. In addition, this role is eligible for an attractive incentive compensation program and benefits. In specific locations, the pay range may vary from the base posted.

Avanos Medical is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity or any other characteristic protected by law.

Join us at Avanos

Join us and you can make a difference in our products, solutions and our culture. Most of all, you can make a difference in the lives, people, and communities around the world.

Make your career count

Our commitment to improving the health and wellbeing of others begins with our employees – through a comprehensive and competitive range of benefits. We provide more than just a salary – our Total Rewards package encompasses everything you receive as an employee; your pay, health care benefits, retirement plans and work/life benefits.

Avanos offers a generous 401(k) employer match of 100% of each pretax dollar you contribute on the first 4% and 50% of the next 2% of pay contributed with immediate vesting.

Avanos also offers the following:

benefits on day 1

free onsite gym

onsite cafeteria

HQ region voted 'best place to live' by USA Today

uncapped sales commissions

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