Patient Access & Reimbursement Manager

The Patient Access and Reimbursement Manager will be responsible for managing and supporting programs to support and educate patients and health care practitioners in Interventional Urology related procedures.   This person will create tools and strategies to support education, coverage, and access within the Interventional Urology business.

Major Areas of Accountability:

• Manage the IU Cares Patient Access Strategy, leading from current state to expand the program by identifying key tactics, defining benchmarks, and identifying opportunities for further investment.
• Collaborate with multifunctional internal teams and customers to complete root cause analysis for procedure cancellations and insurance denials across the IU categories.
• Communicate, negotiate, and build a path forward for common interventional urology related insurance exclusions and denials.
• Partner with marketing and clinical to identify and implement in creation of reimbursement strategy for new product launches and Business Development opportunities.
• In-house expert in the reimbursement process and coding in U.S. and economic dynamics related to Interventional Urology
• Work closely with our Marketing, Sales and National Sales team to create specific evidence and tools to communicate our health economics benefits to key customers, including IDN’s and GPO’s
• Support the development and planning of health economic studies that meet business objectives
• Monitor latest health economic trends and assess impact to our business
• Review and evaluate implications of key scientific publications and payer policies
• Conduct analyses and modeling to assess health economic impact of Coloplast offerings to the healthcare system
• Provide support in data collection activities to Coloplast employees and external stakeholders

• Collaborate with new product development teams early in the process in formulating appropriate reimbursement plans and associated clinical / health-economic evidence development
• Support and execute applications of payer coding and reimbursement requests, e.g., PDAC Coding Verification Requests, HCPCS Code Modification Requests, State Medicaid coding applications

• Conforms with Coloplast Q/EHS Policy
• (http://www.coloplast.com/About/responsibility/Documents/QEHS%20policy.pdf)
• Other duties, as assigned.

Essential Qualifications:

• Bachelor’s degree
• Minimum of 10 years’ experience in a reimbursement and coding.
• Understanding of hospital, ASC, and Office revenue cycle management processes
• Ability to travel up to 20%
• Excellent written and oral communication skills
• Self-driven, pro-active; high-performance and results orientation that can work in a semi-autonomous role
• Ability to summarize multitudes of data into key insights and recommendations
• Must be able to digest complex data while keeping the big picture through good analytical skills.
• Proven ability to effectively partner with all levels and multiple departments across countries to achieve objectives
• Demonstrates both creative and critical thinking skills