Philips Field Director Reimbursement in United States of America - Home Based, Massachusetts
We welcome you to join Philips Image Guided Therapy Devices (IGT-D) as a Field Director Reimbursement – home-based location.
If you are a Colorado resident and this role is a field-based or remote role, you may be eligible to receive additional information about the compensation and benefit package for this role, which we will provide upon request. You may contact 888-367-7223, option 5, for assistance.
US work authorization is a precondition of employment within the US. The company will not consider candidates who require sponsorship for a work-authorized visa.
In this role, you have the opportunity to
The Field Reimbursement Director will work closely with the field sales team to execute reimbursement strategy for Philips IGTD current and future products and procedures. This includes all aspects of coverage, coding, payment, and provider access within hospitals, ambulatory surgery centers, OBL’s, and the physician offices.
This position will be a field-based professional on reimbursement issues and will coordinate field strategies to improve market access to Philips IGTD products and procedures.
Primary responsibilities include developing relationships with public and commercial payor partners to expand coverage; communicating with Key Opinion Leaders to champion efforts to expand patient access; coding strategies at the account level to remove barriers to product utilization; educating customers on appropriate coding related to Philips IGTD products and procedures and strategizing with the regional sales team to improve market adoption.
The position typically requires at least 50% travel but may be as much as 75% travel.
You are responsible for
Lead strategies to expand market access to Philips IGTD products and procedures
Develop and maintain collaborative relationships with Medicare contractors and commercial payors (including Medical Directors, Policy Analysts, Case Managers, Provider Relations Representatives, etc.) to acquire positive coverage decisions that include adequate payment
Develop and maintain relationships with KOLs and state professional society leadership to support reimbursement efforts
Identify and actualize opportunities to expand market access through specialty distributors, GPOs, integrated health plans, and Technology Assessment Organizations/Committees
Identify and establish strategic relationships with large employers or employer groups and patient advocacy organizations to expand patient and provider access to Philips IGTD portfolio
Develop and maintain a comprehensive understanding of regional and local reimbursement coverage issues through payor research, face-to-face meetings, KOL interviews and attendance at public meetings
Facilitate coverage and payment for Philips IGTD products and procedures
Provide strategic support to current customers to resolve coverage denials and/or empower improved contract negotiations to facilitate economically viable payment
Provide internal and external recommendations regarding coding for related services consistent with Philips market approval processes
Delivers presentations to payers to establish and/or improve reimbursement coverage policies, coding and payment assignments utilizing available resources:
Attend regional or national professional society meetings as needed to educate current and potential customers on reimbursement issues and to gain support for market access through policy development
Collaborate with sales team to drive market access
Work cross-functionally within field sales, sales management, and marketing to improve pull-through and demonstrate available resources
Provide market feedback to corporate management on customer business trends, competitive updates and industry issues and opportunities
Serve as a strategic business partner with field sales leadership to prioritize in regional work plan for payor and physician education through frequent communication and quarterly business reviews
Identify and establish relationships with multiple buying influences at account level, especially within the facility C-suite and develop action plans to advance their understanding and support of Philips IGTD products and procedure portfolio. Educate, train and support field sales and internal partners on reimbursement-related issues, including coverage, coding, and payment
Secure and increase number of payor’s covered lives for all product lines
Participate in regional and national sales meetings and local/regional marketing events as needed
Travel with field sales team members to support and educate customers with identified reimbursement challenges and to gain support for payor education strategies through policy and/or clinical guideline development
Daily Activities Include
Provide accurate and current information to Philips IGTD customers to support field sales through management of reimbursement issues and programs, interpretation of policy and training of physicians, facilities and staff members in reimbursement and coding
Assist customers with achieving appropriate reimbursement and understanding reimbursement tactics for meeting payer requirements for documentation of medical necessity
Respond to coverage, coding, and payment inquiries from providers by offering objective information based upon qualified and recognized reimbursement sources that may assist the physician in making an informed coding determination based on the procedure to be performed with a Philips device
Track payer/provider trends by geography
To succeed in this role, you should have the following skills and experience
Bachelor (BA/BS) degree and 10+ years of demonstrated ability in reimbursement / healthcare policy development
Demonstrated knowledge and experience in payer (Medicare, Medicaid, and Private) policies, reimbursement process and the health care legislative environment
Knowledge of managed care and health insurance industry
Experience in interacting efficiently with payer decision-makers, health care reimbursement professionals and local carrier medical directors
Experience in using clinical data to support reimbursement position in presentations
Knowledge of health care provider issues related to reimbursement and practice economics
Experience working with organizational decision makers – marketing, regulatory and sales managers
Experience working directly with sales representatives
Experience working with reimbursement strategies and tactics
Working knowledge of computer software including Word, Excel, PowerPoint and MS Project
Project management skills
Ability to travel to payer and prospective customer/customer sites
Ability to follow and implement policies and procedures required of this position
Detailed knowledge of insurance companies including government payers (Medicare, Medicaid, Tricare) and private payers (PPOs and HMOs) with regard to professional and facility payment systems
Effective communication and presentation skills, strong telephone skills
Attention to detail
Well-organized, self - motivated
Occasional weekend work commitment
Why should you join Philips?
Working at Philips is more than a job. It’s a calling to create a healthier society through meaningful work, focused on improving 3 billion lives a year by delivering innovative solutions across thehealth continuum. Our people experience a variety of unexpected moments when their lives and careers come together in meaningful ways. Learn more bywatching this video
Find out more info about Philips at www.philips.com/na/careers
It is the policy of Philips to provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to race, color, ethnicity, religion, gender, pregnancy/childbirth, age, national origin, sexual orientation, gender identity or expression, disability or perceived disability, genetic information, citizenship, veteran or military status or a person’s relationship or association with a protected veteran, including spouses and other family members, marital or domestic partner status, or any other category protected by federal, state and/or local laws.
As an equal opportunity employer, Philips is committed to a diverse workforce. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants that require accommodation in the job application process may contact 888-367-7223, option 5, for assistance.
Equal Employment and Opportunity Employer/Disabled/Veteran
- Philips Jobs