Director of Health Policy Division:
Arthrex, Inc. (US01) Location:
Arthrex, Inc. is a global medical device company and a leader in new product development and medical education in orthopedics.
Arthrex is actively searching for a Director of Health Policy that will immediately take responsibility for building a new Health Policy team as an internal resource for multiple corporate departments that require fast credible information about coding, coverage, reimbursement and market intelligence. As a result, the successful candidate will be expected to effectively communicate with numerous internal corporate audiences and efficiently manage project requests that will frequently require the assistance of third-party reimbursement consultants.
The position is based at the Arthrex world headquarters campus in Naples, Florida. Relocation assistance may be available along with Arthrex’s incredible employee benefits and work culture. Join our talented Strategic Development team at a growing global medical device company focused on Helping Surgeons Treat Their Patients Better™.
Essential Duties and Responsibilities:
- Triaging internal requests for coding, coverage, reimbursement and market intelligence information.
- Working collaboratively with the requestor, the Director of Health Policy will develop a plan and timeline to fulfill all requests for information, such as Coding and Reimbursement SnapShots for Product Management; Reimbursement Risk Assessments for Business Development; Coding Sell-sheets for customers; and Market Intelligence reports for Product Management.
- Closely monitoring the American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS) and leading payer postings for any new and emerging changes that would impact the Company’s device-dependent procedures.
- Composing strategic reimbursement briefs with recommendations in response to any changes related to AMA, CMS and leading payers proposals.
- Establishing a working relationship with key professional societies, specifically the staffers and members of society Health Policy Committees, such as Coding and Nomenclature, New Technology and Practice Guidelines.
- Supervising third-party reimbursement consultants as they complete project requests in a timely manner.
- Representing the Company and its strategic reimbursement needs by attending important policy meetings taking place across the country and throughout the year, such as Society Scientific Conferences, American Medical Association Current Procedural Terminology (AMA CPT) Editorial Panel meetings, and CMS Town Hall meetings.
- Scheduling and presenting to leading U.S. payers, as need arises
- Up to 15% travel
The above statements describe the general nature and level of work being performed in this job. They are not intended to be an exhaustive list of all duties, and indeed additional responsibilities may be assigned, as required, by management.
Education and Experience:
- Bachelor’s Degree is required. A Ph.D. or Master’s Degree in Health Policy, Health Economics and/or Biostatistics is preferred.
- 10 years’ of relevant experience is required.
- 3 years’ experience within the Healthy Policy, Health Economics, Health reimbursement or similar area within a U.S. medical device manufacturer; preferably as a Strategic Planner or Director. Experience in orthopedics is a plus.
- Proven track record in medical device strategic reimbursement planning required.
Knowledge and Skill Requirements/Specialized Courses and/or Training:
- Relationships with key opinion leaders who are members of select society committees, such as Coding and Nomenclature, New Technology and Practice Guidelines is a plus.
- Practical working knowledge of CPT coding, CMS proposed and final payment rules and leading payer medical policies for musculoskeletal procedures is mandatory.
- Comfort and confidence to formulate the Company’s strategic reimbursement needs when working collaboratively across multiple functional areas, specifically with Regulatory, Product Development, Clinical Affairs, Marketing and Sales leaders.
- Working knowledge of leading health policy agencies, such as CMS Coding, Medical Policy and Payment; AMA CPT Editorial Panel and leading professional societies, such as American Association of Orthopedic Surgeons (AAOS), North American Spine Society (NASS), Arthroscopy Association of North America (AANA), etc.
- In-depth knowledge of procedural coding, persuasive payer communications and market share analysis.
Machine, Tools, and/or Equipment Skills:
Highly proficient in the use of MS Office, Health Policy specialized databases, research tools and internet research tools.
All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.