Director Health Policy and Reimbursement Job

Director Health Policy and Reimbursement Job

Director Health Policy and Reimbursement

Requisition80503
CategoryReimbursement
BusinessCardiac Rhythm Disease Mgmt
DivisionCRDM Clinical Other
LocationUSA-MN-Mounds View
RelocationRelocation eligibility to be determined
Job TypeFull Time - Regular
Exempt/Non-ExemptExempt
ShiftFirst
Travel Percentage10 - 20%
Experience Required12+ years
Education RequiredBachelors Degree

Medtronic is an Equal Opportunity/Affirmative Action Employer


Position Description

The purpose of this position is to proactively protect and improve the CRDM healthcare policy environment through relationship development and management, external environment awareness, knowledge transfer, and advocacy. In this role, the person examines the short, mid and long term opportunities and develops and executes appropriate strategies which minimize penalties and capitalize on opportunities for CRDM.

The position is necessary to provide the critical planning and execution of activities that best position CRDM for success in light of the sweeping changes in our business environment, due to US health care reform. The ability to influence US health policy and identify and engage with emerging entities that impact payment and purchasing decisions is of paramount importance to CRDM's strategic goals. This person will also provide global health policy support through leverage and best practice sharing.

Position Responsibilities

- Performs ongoing surveillance and reporting of the US health policy environment with an emphasis on Health and Human Service (HHS) agencies including CMS and AHRQ as well as those performing Comparative Effectiveness Research and payment policy related to health care reform. Develops and maintains relationships with those agencies.

- Performs ongoing surveillance and reporting of the US health policy environment with an emphasis on relevant US medical specialty societies including HRS, ACC and HFSA; HTA entities including BCBS TEC, ECRI and Hayes and major third party payers including Aetna, Cigna, UHC and Wellpoint. Develops and maintains relationships with those organizations.

- Develops short, medium and long term CRDM policy priorities in conjunction with senior management, Corporate Health Policy and Payment , Government Affairs and reimbursement colleagues. Develops strategies for those priorities and delivers on commitments. This includes global health policy support requiring SBU involvement due to potential impact or where knowledge of US efforts would add value.

- Develops and executes a company-wide Medical Director Advisory Panel and seeks venues and forums to engage with payers/purchasers to gain early insights into reimbursement landscape for the CRDM portfolio.

- Directs CRDM's dialogue with the Federal government, US HTA and third party payers on issues related to the business, working in conjunction with Health Policy and Payment, Government Affairs and other Medtronic business units as relevant.

- Provides strategic and tactical support, including quality assurance for reimbursement colleagues interfacing with external policy organizations. Provides advocacy and coalition work for access to decision makers for reimbursement colleagues.

- Creates or joins coalitions performing advocacy with the Federal government on issues important to the business. Directs data analysis and message creation in support of advocacy efforts, to include defining and executing on specific internal and external data analysis required for coalition efforts.

- Analyzes Medicare payment rules and coding changes affecting the business including inpatient payment, outpatient payment and the physician fee schedule. Reports changes to senior management and reimbursement colleagues. Provides comments within the comment period in conjunction with Corporate Health Policy and Payment.

- Establishes venues to inform senior management, business and reimbursement colleagues regarding changes to the health policy environment and progress toward program goals. Provides ongoing, branded feedback on current issues, characterizing market challenges, business drivers and overall strategic direction. Monitors and reports shifts in the policy environment, HTA or insurance product design that impacts physicians and hospitals successfully integrating these activities with those of other major organizational segments.

Additional Duties/Responsibilities -

- Performs due diligence on potential acquisitions.

- Supports recalls with third party payers.

- Supports the process of economic data gathering through tools development and training, as needed.

Basic Qualifications

* Bachelor's Degree in a Healthcare related Discipline
*12 plus years of Healthcare related work experience
3 plus years of Medical Device or Pharmaceutical Industry Health Policy/Strategic Reimbursement Experience

Desired/Preferred Qualifications

* Master's degree in health policy, health services research, economics, biostatistics, epidemiology, public administration or a related discipline.

*14+ years healthcare work experience including 5+ years device industry or pharmaceutical industry health policy/strategic reimbursement planning experience.

*Able to work independently, guided only by very broad company policies and objectives and make final decisions on issues affecting major segments or functional activities of the organization.

*Able to work collaboratively across a variety of functions and levels. Uses influence and negotiation to reach agreement with external organizations having differing or competing perspectives and objectives.

*Able to apply strong analytical skills to a variety of situations of varying ambiguity.

*Excellent verbal and written communication skills to all levels of the organization including senior management.

Physical Job Requirements

Must be able to sit/stand/walk for up to eight hours per day.