Senior Manager, Payer Relations & Value-Based Offerings

Additional Location(s):  N/A

Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance

At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions.                

 

About the role:

This Senior Manager, Payer Relations & Value-Based Offerings is responsible for supporting Boston Scientific’s senior level strategic relationships with national and regional United States (U.S.) health plans, including integrated delivery network (IDN)-owned health plans. The Senior Manager is responsible for securing market access and coverage for targeted Boston Scientific Endoscopy’s (Endobariatrics) portfolio of products with payers and provider organizations. Develops and executes business plans for payer stakeholders, within defined territory, to positively advocate and remove barriers to access and to ensure coverage and reimbursement for Boston Scientific procedures and devices. Payer stakeholders include commercial private and public payers (Health Plans, Medicaid, Medicare), selected complex provider systems and other market influencers. Partners and collaborates with internal and external stakeholders to understand the barriers to access to BSC Endobariatric technologies. This position will report to the Director, HEMA, Endoscopy.

 

Location: This is a field-based, remote position with 75% travel. Will consider any location across the United States.  

 

Your responsibilities will include:

• Managing and leading the development and implementation of national and regional payer activities for BSC Endoscopy’s Endobariatrics franchise working with corporate and divisional staff and key internal and external stakeholders.
• Actively participating in development and execution of practical strategies to secure optimal coverage for BSC products and procedures.
• Executing strategies and tactics for reimbursement and access within targeted local and regional plans for key technologies.
• Leading implementation of tactical planning activities required to achieve strategic coverage objectives including payer team tools, provider access tools, sales team messaging, etc.
• Identifying key health coverage needs for BSC platform products, working with divisional counterparts and health economics and outcomes research colleagues to determine actions required.
• Assessing coverage opportunities and challenges facing the division’s emerging technologies and commercially marketed products.
• Collaborating with leader of national Payer Relations and Corporate Accounts team to leverage partnership discussions whenever possible to support coverage activities and to share contacts and best practices.
• Monitoring policy developments that impact the coverage of BSC products.

 

Required qualifications:

• A bachelor’s degree (B.A. or B.S.) is required; advanced degree is preferred.
• A minimum of 5 years of experience working in coverage determination and utilization management within a commercial payer organization.
• Established network of Medical Directors and health insurance plans (AHIP, NAMCP, etc.)
• Experience with Medicare and Medicaid coverage strategy.
• Deep knowledge of healthcare, managed care strategy, pricing and the medical reimbursement environment required.
• Prior strategic account management responsibilities or equivalent relationship development or consulting experience with one of the following: payers, government agencies, IDNs, Accountable Care Organizations (ACOs).
• Proven ability to successfully interact with the C-suite.