Field Reimbursement Director

Life Unlimited. At Smith+Nephew we design and manufacture technology that takes the limits off living. The Director, Field Reimbursement with manage the Field Reimbursement Manager (FRM) team within the Wound Reimbursement group and act as the leader and primary reimbursement expert supporting the field in all areas related to reimbursement for the Wound franchise.

What will you be doing?

The Director, Field Reimbursement and the FRM team will execute company strategies related to field reimbursement initiatives including patient and HCP on-boarding and education, spot checks, compliance, incident reports, resource review and communication.  This role will support the company to achieve its mission to connect patients, providers, and payors and ensure patients can access best-in-class technologies and products. This position reports to the V.P. of Strategic Customer Support. This role will be responsible for the development and implementation of field reimbursement support strategies, team organization, hiring, and deployment, educational campaigns for internal and external stakeholders, collaborating with hub services, market access, sales, marketing, training, compliance, and finance as it relates to reimbursement support.  The Director will measure performance of the FRM team based on defined KPIs, provide frequent performance reports to the Sr. Director, coach and develop FRM team members, interface with customers, HCPs, hospital staff and administration on behalf of patients, and work closely with the hub services teams and market access teams to respond to a dynamic payer landscape. The Director is responsible for leading efforts for reimbursement/coding guide updates, assisting with the launch and deployment of technology solutions for the FRM team, acting as a liaison with finance and collections to investigate reimbursement issues, and making recommendations to improve processes, content, and strategy related to Wound Reimbursement. The Director will work closely with Sales, IVR team and Payer Relations.

The Director will also perform the FRM duties for a smaller region

Responsibilities:

·       (30%) Manage FRM team and track performance against KPIs and business objectives

·       (30%) Interface with customers, payers, and external parties

·       (30%) Internal cross-functional support, education, and collaboration  

·       (10%) Team Development and Ad Hoc Projects

Education: Bachelors in Business, Health/Life Sciences, Management, Healthcare Admin, or related field.  Masters Degree in Public Health or Business Administration preferred

What will you need to be successful?

Minimum of 8 years in the biotechnology, pharmaceutical, or medical device industry.

Minimum of 5 years of experience in a field reimbursement or market access role

Must possess strong knowledge of CMS' codes, regulations, LCDs, MAC, reimbursement methodologies by setting of care, and Medicaid fee schedules,

Must possess strong organizational skills and track record of leading successful teams.

Prior experience leading field reimbursement teams is preferred

Prior experience in medical device sales or pharmaceutical sales (buy-and-bill) preferred

Prior experience in wound care preferred

Must already have experience directly influencing stakeholders for strategic cross-functional projects, or evidence of strong leadership skills or project management success

Exceptional work ethic. Uses time productively to maximize efficiency, and meets challenging work goals.

Must possess outstanding oral, written, and interpersonal skills, to quickly develop relationships with internal and external partners.

Has good business acumen, innovative thinking, and problem-solving skills to make decisions with an acceptable return on investment of time and resources. 

Excellent understanding of medical device, biologic or pharmaceutical industry reimbursement environment (CPT, HCPCS, MAC, LCD, OPPS, etc.).

Ability to understand and explain complex disease state information, clinical outcomes data, healthcare economic data, and scientific product information.

Certified Coder or Biller is a plus

Travel Requirements:  Up to 65%

You Unlimited.

• Inclusion, Diversity and Equity - We are committed to welcoming, celebrating and thriving on Diversity! Learn more about Employee Inclusion Groups on our website (https://www.smith-nephew.com/)  
• Your Future: 401K Matching Program, 401k Plus Program, Discounted Stock Options, Tuition Reimbursement  
• Work/Life Balance: Flexible Personal/Vacation Time Off, Paid Holidays, Flex Holidays, Paid Community Service Day  
• Your Wellbeing: We offer Medical, Dental, Vision, Health Savings Account (Employer Contribution of $500+ annually), Employee Assistance Program, Parental Leave, Fertility and Adoption Assistance Program  
• Flexibility: Hybrid Work Model (For most professional roles)  
• Training: Hands-On, Team-Customized, Mentorship  
• Extra Perks: Discounts on fitness clubs, travel and more! 

Smith+Nephew provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability.