HistoSonics is a medical device company, founded in 2009, that has developed a non-invasive, sonic beam therapy platform that uses histotripsy, which is capable of destroying targeted liver tumors. Our mission and passion are to advance the novel science of histotripsy and its powerful benefits, bringing meaningful and transformational change to physicians and their patients.
Location: Remote US: 1 position - East Coast (Eastern Time Zone), 1 position - West Coast (Pacific Time Zone)
Travel: 20% for trade shows and to visit accounts/sites.
Position Summary:
To support the successful growth of Histosonics commercialization the Reimbursement/Health Economics team is expanding with “Reimbursement & Health Economics Manager” to support the sales team and Histosonics physician and hospital accounts. This newly created and vitally important position will be responsible for the management and execution of reimbursement strategies to optimize Histotripsy patient access and mitigate provider reimbursement barriers. Primary responsibilities include account reimbursement support (coding, coverage and payment) as well as executing strategic local payer outreach. This position will collaborate with sales, marketing, professional education and the reimbursement prior authorization and claim support team as well as maintaining close communication with physicians, their office staff and hospital accounts. The position is field based.
The Reimbursement and Health Economics Manager is the Histotripsy accounts and sales team lead contact for all market access, including reimbursement education, assistance, support and issue resolution.
Responsibilities:
- Identify physician and hospital reimbursement hurdles and work with the account and prior authorization team for resolution.
- Lead reimbursement account calls, meetings and discussions with new and existing accounts.
- Support field sales reps with all aspects of new and existing account reimbursement needs.
- Develop and conduct health care economic and reimbursement sales and account implementation, onboarding, education and training (i.e. reimbursement processes, claim submissions procedures, payer coding requirements, coverage landscape, hospital CCR and FAQ’s) for external customer (hospitals, physicians) and internal customers (sales) and appropriate stakeholders.
- Communicate value messaging, reimbursement issues and coverage strategies
- Trouble shoot, forecast and assess hospital and physician Histotripsy coverage and payment issues
- Call on local payers to request coverage and establishment of appropriate payment.
- Manage deliverables such as reimbursement internal account reporting, dossiers, billing and coding tools/resources, clinical bibliography, reimbursement landscape analyses, consultant driven research
- Proactively monitor external reimbursement environment, customers and competitors to identify opportunities for protecting and improving value proposition.
- Present to a diverse audience, including C-suite executives, physicians, and service line administrators regarding health economic and reimbursement issues with a solutions-oriented focus.
- Develop and implement reimbursement tools and tactics that support providers obtaining coverage and appropriate payment.
- Identify key decision-makers within a hospital administration (charge master, CFO, compliance, provider contracting) for reimbursement presentations supporting adoption.
- Understand, monitor and keep abreast of trends in health economics and reimbursement policies that impact Histotripsy and the competitive landscape.
- Provide actionable assessments of local reimbursement environments to help guide strategy, resourcing and tactical implementation.
- Lead and perform analyses, evaluate options, and develop recommendations to overcome economic barriers to market adoption.
- Lead, plan, and facilitate meetings and working sessions with US local payers and KOLs to influence public/private payers to achieve coverage and payment.
- Travel when needed to support reimbursement execution including site visits to physician practices or hospital administration, sales meetings, product training classes and tradeshows.
- Other duties may be assigned.
Qualifications and Skills:
- Bachelor’s degree in a related field. (Master’s degree preferred)
- 5+ years’ Field Reimbursement Management experience including hospital medical device capital equipment, Category III CPT Codes, revenue cycle management, physician payment, Medicare and private payer payment models, hospital billing and coding systems (charge master, payer contracting, revenue cycle management). Oncology experience a plus.
- Service line administration, or C-suite experience in hospital, physician practice and/or payer setting; health economics and outcomes research; or prior industry reimbursement and health care economics experience.
- A strong understanding of physicians, business/practice managers, payers, and their revenue cycle decision-making systems.
- Thorough understanding of U.S. public and commercial payer models, reimbursement concepts (e.g., coverage, coding, and payment).
- Experience in health policy, health economics, medical device reimbursement, technology assessment, or health care research.
- Understanding of medical / clinical research methods and publication interpretation and ability to use evidence to support value proposition.
- Comfort with working independently and anticipating needs / projects before they formally arise.
- Thorough understanding of clinical and economic data, coding, coverage and payment issues, including issues that are unique to the reimbursement and market adoption of new technologies.
- Experience positioning clinical data/studies in support of reimbursement and economic value propositions to providers, societies, commercial payers, and Medicare.
- Demonstrated knowledge and medical device experience with US private payers and Medicare reimbursement.
- Ability to assess payer medical policies.
- Comprehensive knowledge of private payer payment methodologies and contracts.
- The ability to make effective presentations to providers and payers
- High level of interpersonal skills: influencing, resolving conflict, and creative problem solving.
- Must be an excellent communicator using all available channels. Strong written, verbal and presentations skills with the ability to present, persuade and physicians, hospital administrators and key opinion leaders with respect to the Company’s products and clinical strategies.
- The ability to research and strategically apply technical reimbursement knowledge to a variety of business situations.
- Comfortable working virtually, with flexible workplace arrangements and business virtual technologies.
- The ability to manage complex problems and projects while exercising independent decision-making and analytical thinking skills, with minimal supervision.
Salary Range: $140,000-$170,000, plus bonus.
Benefits: We offer a comprehensive benefits package for full-time employees. This includes health, dental, and vision insurance, life, short-term and long-term disability insurance, 401(k), paid time off, and more.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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