Sr Director, Health Care Economics & Reimbursement, Diabetes Business Group
Northridge, California, United States
Oct 01, 2019
This position is responsible for directing and executing the overall global reimbursement strategy for existing and future products. This includes economic data creation to meet global payer needs and influence health policy to shape future reimbursement for diabetes care. This position maintains high-level relationships with third party payers, creates global strategic reimbursement plans, provides input to clinical trial design to meet the needs of payers, leads the health economics team that creates economic analyses and claims data analyses, leads advocacy and coalition work to meet the needs of payers, serves as the principle spokesperson for Diabetes with Medicare, and advances the field organization's knowledge and comfort level with reimbursement. This position also has responsibility for the Value Based Health Care efforts for the business providing direction, prioritization and domain expertise for the business's VBHC efforts.
The Sr Director, Health Care Economics Reimbursement, Diabetes Business, reports to the VP, Customer Solutions Diabetes and is a member of the Customer Solutions Senior Leadership Team.
Directs the Diabetes process for developing global product-specific reimbursement strategies based on the requirements of technology assessment organizations and payers, including Medicare, NICE, etc. Interacts with Vice Presidents of Marketing, Legal, Rand D, Clinical, Government Affairs, Corporate and Global reimbursement counterparts to drive Diabetes reimbursement requirements through the product development and launch processes.
Provides leadership to product development teams to ensure that global payer requirements are identified and that appropriate cost and outcomes data are incorporated into product and clinical trial plans through the product development process.
Manages the Diabetes health economics and outcomes research (HEOR) team. Responsible for planning, budgeting, implementing, and maintaining economic analyses and claims-based data analyses for the Diabetes products and therapies to demonstrate value, inform strategy, and gain insight across the product life cycle. This includes evaluation and analysis of the economic impact of products and therapies on health care systems, including government and third-party payers. Generates economic analyses to support the development and implementation of EV/VBHC strategies for the business.
Represents Medtronic Diabetes, in close coordination with Corporate Reimbursement and Health Economics, to CMS. Serves as the prime internal and external contact on matters related to reimbursement for Diabetes products and therapies. Directs Diabetes input to payer national coverage policy by supplying and framing clinical data and through coalition advocacy.
Represents Medtronic Diabetes to the corporate VHBC Council.
Directs the Diabetes compliance clinical trial program to meet Medicare legal requirements.
Key point of contact supporting and driving reimbursement activities with professional societies, stakeholder groups and advocacy coalitions working toward better Medicare/payer coverage of advanced diabetes technologies.
Directs activities related to training physicians and field representatives regarding basics of Reimbursement for Diabetes products and therapies. Work with Managed Markets staff to assure that their approach with payors is consistent with our reimbursement strategy.
Responsible for developing, executing and updating therapy-focused payor training for new and advanced sales specialists, clinical education specialists, and other departments within the organization.
Oversee the development of external publications, as it related to the reimbursement strategy. Ensure appropriate exposure of information is communicated to internal and external audiences (e.g. field sales staff, European colleagues, etc.)
**Must Have: Minimum Requirements**
Bachelors degree required
Minimum of 15 years of relevant experience with 10+ years of managerial experience , or Advanced Degree with a minimum 13 years prior relevant experience, minimum of 10 years of managerial experience
**Nice to Have**
Advanced degree in health policy, health services research, economics, or related discipline.
10 plus years experience in reimbursement strategy, health economics
Understanding of project intake chartering and management to ensure to internal stakeholder alignment and delivery
Demonstrated knowledge of managed care, health insurance policies, and payor/provider procedures
Understanding of dynamic health care environment
Demonstrated ability to work with organizational decision makers -- Boards, CEO's, political groups, etc.
Ability to maintain proactive relationship with payors, providers, and government agencies
Demonstrated use of business and financial measures, as well as economic modeling, and the impact on reimbursement issue resolution
Demonstrated ability to understand and educate customers on the impact of economic analysis and develop practical solutions
Excellent communication and presentation skills -- written and verbal
Demonstrating ability to negotiate and utilize effective influencing and sales skills
Work experience directly in a clinical or
Work experience directly in Medical Device industry
Knowledge of Diabetes
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**Physical Job Requirements**
The physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. For Office Roles: While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers. Contact your manager or local HR to understand the Work Conditions and Physical requirements that may be specific to each role. (ADA-United States of America)
It is the policy of Medtronic to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Medtronic will provide reasonable accommodations for qualified individuals with disabilities.