Field Reimbursement Manager - Northeast

The Field Reimbursement Manager supports patient and market access to Coloplast’s Interventional Urology products by developing and executing reimbursement initiatives. This role works closely with sales teams, healthcare providers, decision makers and payers to address coding, coverage, and payment issues that impact patient access and product adoption.  This role sits anywhere in the Northeast Region of the US. The Field Reimbursement Manager provides expert information to physicians, hospitals, and ambulatory surgery centers on reimbursement related to Interventional Urology Coloplast products. They provide accurate and objective information and materials to Health Care Professionals regarding Coloplast’s technologies, including identifying coverage, codes, and billing options that may apply to relevant Interventional Urology procedures. The ideal candidate is patient-focused, knowledgeable about medical device reimbursement, and committed to ethical, compliant engagement with healthcare professionals and stakeholders.

Major Areas of Accountability

Collaborative Responsibilities

• Develop reimbursement tools and materials by contributing subject-matter input and supporting creation, refinement, and approval of content throughout the review process.
• Develop and Implement reimbursement strategies and tactics for Coloplast procedures to minimize or eliminate coding, coverage, and payment barriers
• Identify, triage, and resolve access barriers in collaboration with internal reimbursement support teams.
• Identify key issues and trends with commercial and government payers and determine and implement appropriate solutions
• Develop a monthly report of provider activities, including regional trends and developments related to appeals, denials, and approvals.
• Collaborate with Health Economics, Medical Affairs, Marketing, and Compliance teams.
• Participate in initiatives supporting new product launches and payment advocacy efforts.
• Ensure compliance with corporate and regulatory requirements.
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Patient Assistance

• Serve as primary field-based expert for reimbursement, coding and coverage
• Educate administrators, billing managers, and healthcare providers on the accurate and objective use of HCPCS, CPT, ICD-10 codes, modifiers and documentation requirements
• Provide accurate and objective information and materials to HCPs (including administrators, billing managers and other HCPs) regarding Coloplast products, including coverage, codes, and billing options that may apply to Medicare, Medicaid, and commercial payers appropriate Medicare and other payor claims by providing accurate coverage policies and prior-authorization requirements
• Provide one-on-one and group training on prior authorization, claim submission, appeals and payment processes related to Interventional Urology Coloplast products.
• Deliver in-person and virtual reimbursement workshops and policy update and payer landscape sessions to internal and external customers.

• Coloplast employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.
• Other duties as assigned.

Basic Qualifications

• Bachelor’s degree with focus in life science, health economics, healthcare administration, or related field
• 5+ years of medical device/technology industry, pharmaceuticals, managed care and/or health related industry
• Strong understanding and application of principles and concepts in market access, reimbursement and/or health economics
• Experience related to the payer or healthcare provider decision makers (C-suite, administration) physicians, private practice managers.
• Strong business acumen; experience working with various business partners (Sales, Marketing, Medical Science Liaisons, Clinical Program Managers)
• Success in developing and executing strategies and tools that showcase the economic benefit of healthcare for specific therapies and products
• Experience working with he