Director of Market Access and Reimbursement

ItamarAt ZOLL, we're passionate about improving patient outcomes and helping save lives.

We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions.

ZOLL Itamar is an innovative medical device technology company that focuses on the development and manufacturing of Home Sleep Apnea Tests to aid in the diagnosis of respiratory sleep disorders. Our core product is the WatchPAT®️ family, a revolutionary FDA-cleared portable home sleep apnea test device, that is based on proprietary signal and analysis. 80% of patients who have sleep apnea are undiagnosed. We are committed to reach those undiagnosed patients and provide testing to promote wellness and enhance overall quality of life. WatchPAT®️ is commercially available within major markets including the U.S., Japan, and Europe, and is the leading home sleep apnea test in the US. ZOLL Itamar’s corporate headquarters, research and development and manufacturing are located in Israel with U.S. headquarters based in Atlanta, GA.

Job Type

Remote

Job Summary

Director of Market Access & Reimbursement will be responsible for the coordination and growth of our market access and reimbursement initiatives in North America (US & Canada). As part of this role, the Director of Market Access & Reimbursement will manage the US reimbursement team and the consultants we work with. To be successful in this position, person must be able to handle both the tactical level (i.e. support RSMs and providers with denials, billing, reimbursement education etc.) as well as understand and interact with payers on a higher level of reimbursement discussions. The Director of Market Access & Reimbursement will lead payer's policies' monitoring and submissions for updating them when needed, to increase our products coverage and reimbursement rates. In this position a person must be able to work independently, be proactive and creative and know his/her way in the reimbursement regulatory maze. This position will work closely and in coordination with our sales organization, leadership team and Regional Sales Managers, as well as other field professionals. The Director of Market Access & Reimbursement will report to the VP Strategic Planning & Health Economics.

Essential Functions

• Understand and follow reimbursement guidelines and policies to include timely updates and communicate changes that affect reimbursement to management (we currently monitor policies of more than 300 payers in the US, each has at least one policy).
• Keep track of payers’ policies and coverage of our products, what restriction do they have and decide if a change is needed to improve our products’ reimbursement.
• Monitor and analyze relevant guidelines and provide published data to company relevant staff. Provide data to address reimbursement challenges, such as utilization of our products (and competitors), number of covered lives per payer etc.
• Contact and negotiate with insurance companies regarding denials as well as policy issues.
• Develop and execute a market access and reimbursement strategy in Canada to approve coverage of our products.
• Support the ZOLL IDTF reimbursement team to increase coverage and reimbursement rates in the IDTF contracts with payers.
• Responsible for all reimbursement training for new hires, specifically in out field force.
• Point of contact for our field force (ABDs, RSMs) and others when they need to understand coverage issues, or once they encounter a reimbursement problem.
• Manage the US reimbursement team to resolve reimbursement issues in the field and support our field force.
• Address denials (why and how to solve).
• Educate providers about home sleep testing reimbursement.
• Provide timely and effective solutions aligned with company needs.

Required/Preferred Education and Experience

• Bachelor's Degree in health-related or similar field required
• 5+ years of reimbursement or comparable experience preferred
• Professional Coding Certification highly preferred preferred

Knowledge, Skills and Abilities

• Proven experience dealing with insurance companies and payors.
• Experience in Cardiovascular or Sleep Apnea - required.
• Experience with reimbursement of medical devices – preferred.
• Experience in working with specific tools monitoring payers’ policies such as “Policy Reporter” or others.
• Proven negotiating and customer relationship management skills with the ability to navigate a complex process.
• Ability to effectively manage assigned accounts in terms of problem resoluti