Market Access & Reimbursement Analyst
Market Access & Reimbursement Analyst
The Market Access & Reimbursement Analyst will support the development and execution of U.S. coverage and reimbursement strategy through engagement with U.S. Commercial, Worker’s Compensation payer organizations and Medicare Administrative Contractors (MACs). The Market Access & Reimbursement Analyst will provide support in the understanding of coding and payment for Government and Commercial Payers and navigate through reimbursement challenges to increase access including but not limited to monitoring, identifying, and resolving reimbursement concerns and other issues with appropriate external customers, patients, and internal teams.
PRIMARY RESPONSIBILITIES
- Track policy status changes, evaluate, assess and report changes, highlighting the impact to SPR therapies and communication to internal stakeholders related to coverage policy changes.
- Maintain database of key payer decision makers, policy staff and medical directors.
- Organize and support SPR’s Coverage Campaign through digital communications and engagement.
- Enhance, create, or improve existing data reports, and/or develop reports that are needed for Market Access team or business needs.
- Support the Market Access team’s collaboration with local physician champions and important stakeholder groups (e.g., patient advocacy groups) to deliver effective engagement with payers.
- Partner with customer-focused teams for Market Access and HEOR KOL engagement and coordination necessary to execute SPR’s Market Access and evidence generation strategy.
- Provide support to and develop relationships with patient access stakeholders including office management, institution administrators, billing and coding staff, internal teams, and other individuals to deliver information that facilitates patient access.
- Assist in the development and implementation of reimbursement strategies and programs to improve payment and reimbursement practices between payer/providers.
- Collaborate with legal, compliance, and other internal stakeholders to assure appropriate engagement processes are adhered.
- Work on other market access projects as requested and needed.
KNOWLEDGE AND SKILL REQUIREMENTS
Experience, Competencies, Education:
- Bachelor’s degree required
- Two or more years Medical Device Industry Health Policy / Reimbursement experience.
- Individual must obtain CPT coding certification within 1 year of hire
- Understanding of US healthcare payment systems and healthcare trends
- Experience reviewing commercial coverage policies and Medicare payment regulations
- Excellent verbal and written communication skills, especially in a healthcare environment
- Well versed with MS Office
- Experience with SalesForce required
Beneficial Skills and Experience:
- Experience in Medical Device or other related industry market access/health economics experience
- Project management experience leading cross-functional teams
- Able to work independently
- Able to apply strong analytical skills to a variety of situations of varying ambiguity
WORKING CONDITIONS
- Ability and willingness to “get the job done”, allowing for flexible and extended hours, depending upon the project needs
- Small office environment (does own documentation and interacts directly with others in virtually all situations)
- Travel up to 20% (primarily attending internal meetings, conferences and trainings)