Manager, Market Access and Reimbursement – East

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October 17

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Artex Risk Solutions

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Finance • Insurance • Risk Management

Artex Risk Solutions is a leader in alternative risk management, providing innovative solutions for both large and small organizations. They specialize in creative risk management strategies that help clients optimize their cost of risk, leveraging expertise in capital solutions, specialty risk transfer, and carrier outsourcing services. With a global presence and a commitment to challenging traditional approaches, Artex aims to empower businesses to make informed risk management decisions and enhance their operational efficiency.

501 - 1000 employees

Founded 1997

💸 Finance

📋 Description

• Manage special projects (e.g., internal hotline, Chatter) and corresponding activities with accountabilities for successful completion. • Educate and train Arthrex’ Sales team and respective agencies, as assigned, on all aspects of U.S. reimbursement (coding, coverage, payment, and contracting) for the product portfolio and messaging in-person, virtual meetings and on-demand phone calls. • Develop, manage, and deliver reimbursement educational programs for Arthrex internal (sales reps. & sales leadership) and external (surgeons, hospitals, ASCs, payers) customers. • Collaborate with Marketing, Sales, Product Management and Regulatory teams to anticipate market needs and inform the development of customer-facing tools, economic models, and other tactical elements of reimbursement to maximize patient access to Arthrex’s technologies and products. • Work in partnership with Sales and Sales leadership to plan and prioritize key customer visits, virtual and in-person, to provide education, and deliver value-based messages to drive patient access. • Develop and implement reimbursement, market access, and value-based strategies to promote broader access for patients, in alignment with commercial objectives. • Develop and support relationships with local physician champions to support interactions with payors. • Monitor and research reimbursement trends, market changes, coverage issues, coding developments, payment methodologies and communicate recommendations. • Triage and manage routine internal and external requests. • Travel up to 40%. • Ensure compliance within functional areas and support the compliance objectives of the organization as a whole.

🎯 Requirements

• 5+ years of experience working in the delivery and/or administration of healthcare, healthcare insurance plan or the medical device industry required • Bachelor's degree required • Master’s Degree or other advanced degree is a plus • Experience in Orthopedic medical devices desired but not required • Prior field reimbursement experience in medical devices desired but not required • Certified Professional Coder (CPC) credential or willing to obtain within 1 year of hire date • Detailed knowledge of medical device billing, coding (e.g., CPT, HCPCS, ICD-10, APC, DRG) • Detailed knowledge of payer coverage requirements, Prior Authorization, claim submission, adjudication, and appeals processes • Knowledge of U.S. health care policy, payment systems and contracting methodologies, including Medicare and commercial payers, in inpatient and outpatient, physician office, and ASC/HOPD sites of service • Ability to train sales team members both individually and in groups regarding coding, coverage, reimbursement, and contracting concepts in a way that is easy to understand, credible, and engages the audience • Demonstrated responsiveness and sense of urgency when pursuing goals and completing tasks • Demonstrated ability to set and manage priorities, while managing multiple projects • Ability to work with ambiguity and continuously adapt in a rapidly changing atmosphere • Experience working as part of both functional and cross-functional teams • High customer service orientation with outstanding people skills, including developing relationships at all levels in an organization and directly influencing business objectives • Ability to effectively prioritize and implement multiple workstreams in a dynamic environment of multiple stakeholder audiences • Ability to work independently and effectively with minimal supervision • Demonstrated skills in account management and customer service, including use of CRM (e.g., Salesforce) • Computer literacy (remote connectivity, Microsoft Office Suite) • Must have a valid driver’s license with a clean motor vehicle record • Must be able to travel throughout the U.S. via plane, train, or vehicle

🏖️ Benefits

• Medical, Dental and Vision Insurance • Company-Provided Life Insurance • Voluntary Life Insurance • Flexible Spending Account (FSA) • Supplemental Insurance Plans (Accident, Cancer, Hospital, Critical Illness) • Matching 401(k) Retirement Plan • Annual Bonus • Wellness Incentive Program • Gym Reimbursement Program • Tuition Reimbursement Program • Trip of a Lifetime • Paid Parental Leave • Paid Time Off • Volunteer PTO • Employee Assistance Provider (EAP)