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Senior Reimbursement and Health Policy Analyst- Diabetes

Location: Minnesota Lake, MN 56068
Type: Non-Remote
Posted on: September 19, 2023
This job is no longer available from the source.
The Senior Reimbursement and Health Policy Analyst serves as a key partner to the business on reimbursement issues. The role supports internal payer/pharmacy benefit manager contracting and sales teams as well as external health care provider customers on US reimbursement and relevant policy topics for commercialized products. The role works in close partnership with reimbursement consultants as well as functional colleagues in health economics & outcomes research to define the strategic direction for new products, deliver business requirements related to reimbursement throughout the product development process, and support tactical implementation.
The Medtronic Diabetes Business is one of the most exciting, dynamic and challenging spaces in the medical device industry. More than 463 million patients worldwide suffer from diabetes and this is expected to reach close to 600 million in 10 years. The diabetes device industry is unique in that technologies available to monitor and manage diabetes are starting to converge with consumer electronics technology. As such, the decision dynamics are evolving: patients have a stronger voice in therapy choice, care is transitioning away from specialists, and the role of artificial intelligence is elevating care. Medtronic Diabetes is transforming its business to adapt to this change and create meaningful differentiation to drive customer preference and revenue growth.
+ Serve as a key partner to the business on reimbursement topics for commercialized products
+ Develops and implements reimbursement strategies and programs to obtain coverage, coding and payment from payer/providers.
+ Provides reimbursement-related advice to product development teams, marketing, sales, regulatory, clinical and business leaders.
+ Identifies payer opportunities and issues and implements programs to resolve/decrease barriers to entry for the company's products or therapies.
+ Works closely with Health Economics and Outcomes Research staff to evaluate the economic impact of the use of therapies/products on payers, including the government.
+ Create presentation templates for US reimbursement updates to leadership.
+ Collaborate with reimbursement consultants to define the strategic direction for products in the pipeline, develop global reimbursement deliverables as part of the product development process, and support tactical implementation.
+ Perform environmental scanning on topics pertinent to reimbursement in the diabetes space including for competitive products to support strategic and tactical planning.
+ Serve as a liaison to global health economics, policy and reimbursement colleagues in Latin America (LATAM) and Canada.
+ May create training and deliver education programs to sales force, physicians, home care agencies, case managers, hospital CFO's, medical directors, billing personnel, and pharmacists in clinics and hospitals
+ Maintain comprehensive knowledge of the coding and reimbursement rules and regulations relevant for diabetes therapies of the Centers for Medicare and Medicaid Services (CMS) and major commercial payers in the U.S.
+ Identify need, create, communicate/disseminate/deliver, and maintain internal and external customer-facing reimbursement tools and information (e.g. regional reimbursement colleagues, sales force, health care providers, medical directors, billing personnel, distributors).
+ Capture statistics to report impact to business leadership on reimbursement interactions with internal/external customers.
+ Respond to internal and external U.S. customer reimbursement inquiries in a timely manner.
+ Partner with US payer & pharmacy benefit manager contracting teams on critical coding, coverage and payment issues for commercialized products, helping identify issues/opportunities and issues as well as providing support to decrease barriers.
+ Collaborate with market access/payer marketing team on materials creation.
+ Provide analytical support on the reimbursement status of diabetes therapies and health policies impacting reimbursement.
+ Maintain code tracking spreadsheet with annual Medicare payment rate changes over time (PFS, OPPS, DME fee schedule).
+ Track, analyze and report statistics on Medicare and commercial payer coverage for diabetes therapies.
+ Bachelors degree and minimum of 5-7 years experience in health policy, reimbursement, health economics, or other field with direct relevance to the role, or advanced degree with a minimum of 5 years prior experience in the same
+ Demonstrated knowledge and understanding of U.S. healthcare reimbursement mechanisms (Medicare and commercial payment systems, pharmacy channel reimbursement, third-party payer coverage, clinical/procedural coding) and payment regulations related to medical devices
+ Project management experience
+ Experience with coding, coverage, and payment for medical device technology and/or durable medical equipment (DME)
+ Experience with reimbursement issues under the US Medicare Part D/pharmacy benefit
+ Able to work independently, cross functionally and as part of a team to problem solve and seek advice when necessary, performing work with limited oversight and supervision
+ Able to manage multiple tasks with high degree of organization
+ Able to apply strong analytical skills to a variety of situations of varying ambiguity
+ Able to make recommendations and implement process improvement opportunities
+ Working knowledge of federal and/or state regulations pertaining to regulatory rules and coverage policies for therapies to manage diabetes
+ Excellent verbal and written communication skills; competent and engaging presenter
+ Medical coding certification, e.g. Certified Professional Coder (CPC)
+ Ability to travel: 10 20%
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position. The physical demands described within the Responsibilities section of this job description 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 be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus in relation to travel and operating a personal computer. Travel is required. Must be able to drive approximately 85% of the time within assigned territory and may require overnight travel. Ability to drive over four hours consecutively. Must have a valid driver's license and active vehicle insurance policy. In addition, your driving record will be reviewed and will be considered as part of your application. For Office Roles: While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers. Contact your manager or local HR to understand the Work Conditions and Physical requirements that may be specific to each role. (ADA-United States of America)
A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create. We offer a wide range of benefits, resources, and competitive compensation plans designed to support you at every career and life stage. Learn more about our benefits here (\_name=signon&co\_num=30601&co\_affid=medtronic) .
This position is eligible for a short-term incentive plan. Learn more about Medtronic Incentive Plan (MIP) on page 6 here .
The provided base salary range is used nationally (except in certain CA locations).The rate offered is compliant with federal/local regulations and may vary by experience,certification/education, market conditions, location, etc.
Together, we can change healthcare worldwide. At Medtronic, we push the limits of what technology can do to help alleviate pain, restore health and extend life. We challenge ourselves and each other to make tomorrow better than yesterday. It is what makes this an exciting and rewarding place to be. We can accelerate and advance our ability to create meaningful innovations - but we will only succeed with the right people on our team. Lets work together to address universal healthcare needs and improve patients lives. Help us shape the future.
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It is the policy of Medtronic to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Medtronic will provide reasonable accommodations for qualified individuals with disabilities.