ETS- Director/Leader of Reimbursement

Job Description

Hands-on working manager who owns the reimbursement and market access functions, including day-to-day reimbursement support for customers and sales reps, management of a 3rd party reimbursement service provider, and payer strategy and execution to secure coverage and payment.

Products

• MIRRAGEN Advanced Wound Matrix is a synthetic, bioresorbable glass fiber technology intended to support the body's natural wound healing processes. The additional products in the Mirragen family will have other properties and be used in different settings such as the Operating Room.

Minimum Requirements

• Experience in a small company or start-up environment.
• Effective and efficient in a remote work environment
• Certified Professional Coder is a plus
• Extensive knowledge of CMS and private payer requirements for coding, coverage, and reimbursement
• Proven understanding of reimbursement methodologies by site of care (e.g., hospital inpatient, outpatient, ASC, physician's office, etc.)
• Understanding of Medicare and Medicaid programs, preferably including coverage and payment for medical devices and biologics as Medicare Part B drugs.
• Experience gaining product coverage with commercial and government payers.
• Experience in wound care preferred, ideally with biologic or skin substitute products.
• Hands-on and versatile mindset is required to succeed in a small company or start-up environment.
• Exceptional written and verbal communication skills; demonstrates discretion, confidentiality, and professionalism when representing the company.
• Strong analytical and problem-solving capabilities; working knowledge of data analysis, statistics, and performance metrics.
• Proficient in the Microsoft Office suite (i.e. Excel, PowerPoints, etc.), Power BI a plus

Education:

• 8+ years experience in healthcare reimbursement, coding, and market access; preferably in wound care.
• Bachelor's or advanced degree in business, healthcare administration, health sciences, engineering, or related field.

Job Requirements

• Lead and perform virtual and in-person reimbursement activities including health care provider (HCP) on-boarding and education, sales training, and day-to-day reimbursement support.
• Manage 3rd party reimbursement service that provides benefits verification, prior authorization, and hotline support for healthcare providers.
• Liaison with HCPs (ETS Customers), sales reps, and a 3rd party reimbursement service provider to resolve day-to-day reimbursement issues, improve customer service, and maximize reimbursement success.
• Educate and support customers on billing, coding, and national & and local payer coverage policies.
• Develop and maintain relationships with decision-makers within government and commercial payers.
• Develop and execute strategy and initiate to establish and expand coverage and reimbursement for ETS products with commercial and government payers.
• Analyze reimbursement success, and proactively identify and recommend growth opportunities for ETS products.
• Work cross-functionally to create customer-facing collateral that supports field sales education, provider reimbursement, and payer advocacy initiatives.
• Owns the reimbursement and market access functions; identifies needs, and solutions, and drives actions through to completion. Takes personal accountability for end results.
• Hands-on leader with success as an individual contributor and strong communication skills; ability to lead projects and small teams.
• Independent and critical thinker, self-starter, solid work ethic, understanding of ethical industry practices.

Compensation Information

• Base: $135k+$175k dependent on experience
• Variable: up to 15% Bonus
• Total Comp: $150k-$200k

Location

• This is a remote role. Preferred location in Minneapolis-St. Paul, MN or St. Louis, MO (both near ETS hubs), or in a US location with access to a major airport. Travel up to 35%.