Sr. Director of Reimbursement

Position Overview

The Sr. Director of Reimbursement provides leadership, strategic direction and overall management of all reimbursement functions and activities to ensure that the Company’s reimbursement objectives are met.  The Sr. Director of Reimbursement serves as the primary contact between the Company and government and commercial payors, medical specialty societies, healthcare professionals and others. 

The Sr. Director of Reimbursement is responsible for collaborating with the Company’s leadership team to establish and maintain appropriate ethical and compliant leadership.  Adherence to and promotion of the Company's Compliance Program, the AdvaMed Code of Ethics, the Company Code of Conduct, FDA regulations, privacy laws, federal anti-kickback statute, foreign corrupt practices act, anti-bribery and anti-corruption laws.  The employee must at all times act and conduct company business in an honest, ethical and strictly legal manner, complying with the Code of Conduct, other company policies, the AdvaMed Code and all applicable laws and regulations, whether national, regional, state or local. This individual is encouraged, expected, and required to report any suspected violations of laws, regulations, the Code or any other Company policy, and all other suspected unethical behavior. The company does not tolerate retaliation in connection with making good faith reports of suspected violations.

The Sr. Director of Reimbursement will report to the VP of Product & Reimbursement.

Responsibilities & Skills

Market Access:

• Provide leadership, strategic planning, direction and implementation of US market access and reimbursement initiatives
• Lead assessment of industry trends and interpretation of US healthcare regulations and health care system evaluation related to the Company's primary industry and geographic markets. Anticipate trends and changes to align market access strategy
• Develop payor value proposition and robust Health Technology Assessment (HTA) strategy and tools to prepare HTA markets to overcome payor challenges for Company's products.
• Maintain strong working relationships with all key partners

Coding:

• Knowledge of the various healthcare coding systems (ICD, CPT, HCPCS) and how to obtain appropriate codes for the Company's products and procedures
• Experience with medical specialty society leadership to gain support for new products and/or procedural codes

Coverage/Payment:

• Research reimbursement trends, coverage issues, and payment methodologies
• Guide global health economic evidence strategy. Partner with Clinical, Medical Affairs, and Product to provide endpoint recommendations to generate health outcomes evidence in clinical trials and identify post-market data needs
• Monitor and examine the national and regional payer policy status related to the Company's products and other contending technologies or procedures
• Identify challenges and opportunities with both commercial and public payers and develop strategies to expand payer coverage and drive exclusive coverage or other reimbursement policies that augment the competitiveness of the company
• Develop and maintain materials with which to engage payers and providers (literature, product information, dossiers, presentations, economic models, template letters, etc.) and identify appropriate executives to contact within payer organizations
• Collaborate with Marketing and Sales to develop advocates among Healthcare professionals to improve payer outcomes on both local and national levels

​Requirements/Qualifications

• Minimum 7 years' increasing responsibility in reimbursement with direct experience interacting with payers and influencing coverage policy as well as experience building and leading teams
• Minimum 3 5 years' reimbursement experience in medical device preferred
• Experience with launch of new technologies
• Experience leading teams amidst rapid growth and constant change
• Able to formulate and execute reimbursement strategy. Knowledge of both US commercial and public payers
• Knowledge and experience with US Medicare, Medicaid and private payer policies, reimbursement process, health policy, areas of coverage, payment, and coding is required for this position
• Experience reviewing clinical literature to develop submissions for payer engagement
• Knowledge and familiarity of applicable regulations/standards (e.g. ISO 13485, FDA 21 CFR 820, EU MDR 2017/745, ISO 14971) as required to perform the job function
• Able to dissect challenges and analyze complex data to derive insights and develop recommendations
• Able to work on multiple projects simultaneously and be flexible enough to change priorities with short notice when necessary
• Must have excellent verbal, written, analytical and presentation skills
• Self-motivated and go-getter
• Able to thrive in a fast-paced environment

Education:

• BA or BS
• MA in health sciences or MBA

What We Offer

• Base + Bonus+  Ceribell Equity 
• 100% Employer paid Health Benefits for the Employee 
• Life & Long-term disability insurance paid 100% by Ceribell
• Flexible paid time off
• 11 Paid Holidays
• Maternity and Paternity Leave 
• Fantastic culture with tremendous career advancement opportunities
• Joining a mission minded organization!