Market Access Manager

Summary

Join Calyxo, a medical device company, as a Reimbursement Manager to support the execution of reimbursement strategy for kidney stone treatment products. You will educate the sales team on coding, coverage, and payment issues, work with customers on reimbursement challenges, and develop reimbursement tools. This role involves researching payer policies, building relationships with healthcare professionals, and attending industry meetings. The position requires experience in medical device coding, coverage, and payment, along with strong communication and presentation skills. Calyxo offers a competitive salary, stock options, and an employee benefits package including 401(k), healthcare insurance, and paid time off. The position is remote, full-time, and requires 10-20% travel.

Requirements

• BA/BS degree in Business, Economics, Basic Sciences or Marketing or acceptable alternative with 7-9 years' work experience in the healthcare industry
• 5-7 years medical device coding, coverage and payment experience
• Functional experience in healthcare consulting, business development, healthcare policy, healthcare economics or medical marketing/marketing research is necessary
• Ability and desire to successfully interact with all levels of management and healthcare professionals including medical office staff, physicians, policy analysts, medical directors, and CMS
• Knowledge of Medicare, Medicaid, and private insurer reimbursement methodology
• Understanding of healthcare benefits (deductible, out of pocket, benefit exclusions, etc.)
• Solid understanding of CPT, ICD-9, ICD-10, HCPCS and POS coding
• Understanding of HIPAA compliance
• Ability to effectively interact with multiple departments and functions; manage completion of multiple tasks
• Ability to prioritize projects and display initiative and flexibility. Detail oriented & strong organizational skills
• Excellent oral presentation skills via teleconference and in person
• Strong technical, written and communication skills
• Proficiency with productivity software including Microsoft Office (Word, Excel, Outlook, PowerPoint etc.)
• Willingness and ability to maintain up-to-date hospital credentialing requirements including all required vaccinations and immunizations
• Travel: 10-20% of time
• Ability to lift 30lbs
• Work location: Remote (work from home)
• Full time employment
• Must be able to sit for up to 8 hours/day
• Compliance with relevant county, state, and Federal rules regarding vaccinations

Responsibilities

• Educate, train and support the sales team on local, regional & national coding, coverage and payment issues
• Work with customers as needed with identified reimbursement challenges and respond as needed to coding, coverage & payment questions from internal and external customers
• Assist in the development and delivery of presentations, correspondence, and reimbursement tools for internal and external customers
• Identify and execute on opportunities to obtain favorable coding, coverage & payment decisions and health technology assessments (HTA)
• Maintain a comprehensive understanding of local, regional and national reimbursement coverage issues through research of payer websites, face-to-face meetings, KOL interviews, and attendance at public meetings
• Research and analyze payer policies and reimbursement as they relate to Calyxo and competitive products
• Develop and monitor a payer database and assist in identifying payer initiatives and appropriate timelines
• Support the development of sales training programs and participate as requested in sales training
• Attend local, regional and national professional society meetings and reimbursement conferences and exhibits as requested
• Other duties may be assigned as a part of job scope
• Lead and monitor the work of others, including outside consultants
• Conduct payor, provider, and sales education to reduce and eliminate coverage and payment obstacles
• Build professional relationships with all levels of healthcare policy decision makers, key opinion leaders, and Calyxo customers

Preferred Qualifications

CPC accreditation preferred

Benefits

• Base competitive salary range of $110,000 - $125,000
• Stock options – ownership and a stake in growing a mission-driven company
• Employee benefits package that includes 401(k), healthcare insurance and paid time off