Senior Manager, Payor Relations

• The Senior Manager, Payor Relations is responsible for forging relationships with payors and industry stakeholders to protect and expand access, as well as gain payor preference for Coloplast Products.
• This includes but is not limited to developing and implementing tools and value propositions for payors, healthcare providers (HCPs), Durable medical Equipment (DME) providers, GPOs, etc.
• These tools may include evidence dossiers, budget impact models, whitepapers etc.
• Ideal candidate will have expertise in interpreting and communicating clinical and economic evidence and Transparency in Coverage data as part of commercial support activities, such as field reimbursement and in-house sales and marketing functions as well as experience developing and implementing tools within medical device and/or DME industry.

Major Areas of Accountability:

• Articulate the clinical and economic value proposition of Coloplast and Comfort products and services, to advocate to payors, hospital administrators and other healthcare decision makers
• Synthesize internal and external data sources, including Transparency in Coverage data, to create messaging, tools, and metrics to support engagements with payors, healthcare organizations (e.g., ACOs, IDNs), DME providers, GPOs, patient advocacy groups, etc.
• Develop materials based on published clinical and economic evidence and internal data demonstrating the nature and quality of services and resulting patient outcomes
• Develop materials and execute patient engagement and advocacy campaigns with payors, DME providers and HCPs
• Partner with Care Advising and Comfort Medical for patient and payor advocacy campaigns
• Develop and maintain a current knowledge of the incentives and performance measures critical for healthcare and DME providers
• Other duties and responsibilities as assigned

Basic Qualifications

• A Bachelor’s degree in healthcare administration, business or a related field is required
• 10 or more years of experience in the medical device and/or DME industry or related field
• Experience advocating for better price and or medical policy coverage with health plans (Commercial, Medicare Advantage, and Medicaid programs) and provider/member organizations (ACOs, IDNs, GPOs)
• Demonstrated excellence in building networks and relationships, clear thinking and problem solving
• Ability to interpret clinical and economic evidence and Transparency in Coverage data to articulate value proposition of Coloplast products and services to payors
• Strong organizational capabilities with the ability to structure complex problems creatively and strategically
• Understanding of coding, coverage and payment constructs for medical devices and associated services across all healthcare settings
• Ability to prioritize and successfully influence stakeholders in a matrixed organization
• Excellent oral, written and presentation communication skills
• Up to 25% overnight travel
• Coloplast employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.

Preferred Qualifications

• MBA, MPH, or other relevant graduate education preferred
• Recent experience with HCP and/or DME providers related to Transparency in Coverage data, value-based care initiatives and population health management
• Experiences with managing and implementing innovative healthcare programs with a good grasp of financial and statistical data and modelling alternative care model designs
• Experience with development of payor and HCP/DME providers focused budget impact models