Market Access & Regional Reimbursement Manager

at Smith & Nephew, Inc. in Chicago, Illinois, United States

Job Description

Life Unlimited. At Smith+Nephew we design and manufacture technology that takes the limits off living.

The Market Access Regional Reimbursement Manager (MARRM) is pivotal in supporting the US Market Access Department's mission to ensure patient access to best-in-class technologies and products for Advanced Wound Management, including Grafix, Oasis, and PICO. The MARRM will focus on government payers (such as Medicare, Medicaid, and Veterans Affairs) and regional commercial payers in executing company goals. The MARRM is the primary contact and expert driving payer strategy to secure coverage and reimbursement for Smith & Nephew Advanced Wound Management products. The MARRM role drives patient access to necessary medical therapies while building a positive reputation for the company within the payer community, which spans over 100 million lives.

Responsibilities of the MARRM include but are not limited to, developing and maintaining relationships with key decision-makers within the regional commercial payers, state health associations, and other relevant organizations. The MARRM influences policy decisions, fee schedules, product coverage, utilization management, and reimbursement payment decisions. Additionally, the MARRM is tasked with developing and implementing payer coverage and reimbursement strategies tailored to secure appropriate access, coverage, and reimbursement for the Smith & Nephew wound care product portfolio across assigned government and commercial payer segments.

Collaboration with the US Market Access Team, Clinical and Medical Affairs, VP of Healthcare Strategy, Healthcare Systems colleagues, and Sales leadership is essential to ensure strategic alignment and successful execution of payer initiatives. The MARRM must possess strong leadership skills and project management capabilities, working collaboratively with cross-functional leads to analyze payer gaps and devise effective strategies. Acting as a business consultant, the MARRM communicates a compelling value proposition specific to the needs of both internal and external stakeholders. This role requires a highly independent and proactive individual capable of driving results in a dynamic healthcare landscape."

What will you be doing?

Develop and maintain strong relationships with decision-makers both government and commercial payers

Analyze, develop and execute on payer strategy and initiatives remove access barriers, new and expanded coverage for product portfolio

Proactively identify and recommend new payer growth opportunities for the product portfolio

Work collaboratively with Sales, Field Reimbursement, and Hotline to ensure company has the latest coverage policies and to remove reimbursement barriers.

Liaison with cross -functional leads to build customer-facing collateral to support field sales education, and payer advocacy initiatives

What will you need to be successful?

Bachelors degree in business, health sciences, management, healthcare administration, or related field

Licenses/ Certifications: Certified Professional Coders is a plus

Minimum of 5 years in the medical device or biotechnology industry

Minimum of 4 years of experience in a reimbursement or market access role

Extensive knowledge of coding, coverage, and reimbursement

Solid understanding of government (e.g., national/local coverage determinations), and commercial payer coverage process

Proven understanding of reimbursement methodologies by site of care (e.g., hospital inpatient, outpatient, ASC, physician's office, etc.)

Understanding of State Medicaid programs and the policy development process

Prior experience growing medical product coverage with payers preferred.

Prior experience in wound care preferred

Familiarity with MDMA, AdvaMed, and other associations preferred

Travel Requirements: Up to 65%

You Unlimited.
We believe in creating the greatest good for society. Our strongest investments are in our people and the patients we serve.

Inclusion, Diversity and Equity: 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... For full info follow application link.

Smith & Nephew is an Equal Opportunity/Affirmative Action Employer -EEO/AA/Minorities/Females/Disabled/Veterans and participates in the E-Verify Program.

As an equal opportunity/affirmative action employer, Smith & Nephew is committed to a diverse workforce. If you are a qualified individual in the US with a disability or a disabled veteran, you have the right to request a reasonable accommodation if you are unable or limited in your ability to use or access Smith & Nephew's career website as a result of your disability. You can request reasonable accommodations by calling Recruitment Support at 1-901-399-6192.