Market Access and Reimbursement Manager - Western States

Region: Americas
Location: Seattle Washington

Advertising Date: Wed 13 October 2021

Sirtex Medical is a global life sciences company with offices in the US, Australia, Germany and Singapore, working to improve outcomes in people with cancer. Our current lead product is a targeted radiation therapy for liver tumors called SIR-Spheres® Y-90 resin microspheres. More than 100,000 doses have been supplied to treat patients with liver cancer at more than 1,300 medical centers in over 50 countries. 

The primary focus of this role is to provide field-based health economics and reimbursement education and support to new and existing Sirtex accounts. This position collaborates with the Director, Market Access and Reimbursement to provide strategic direction and development of regional reimbursement programs to increase private, Medicaid and Medicare payer access. 

This position will monitor and anticipate changing market conditions relative to public and private payer policies and their potential impact on the company business and will work to foster alliances with stakeholders, professional organizations and payer organizations to build continued support for payer coverage. The Market Access and Reimbursement Manager; MARM will manage regional communications concerning issues impacting financial reimbursement for Sirtex products. The MARM will assist in monitoring reimbursement compliance as it relates to industry standards for national, state, and local coding and billing guidelines.

The MARM will be expected to primarily understand U.S. reimbursement policies in a variety of settings, including physician office, hospital outpatient, inpatient and ambulatory surgery centers. The MARM will be required to interact with a diverse customer base, including payer thought leaders, physicians and their office staff, as well as Interventional, Nuclear Medicine and Radiation Oncology hospital managers. The MARM will have the ability to interpret and translate billing, coding, coverage, and payment information and communicate these concepts at all levels of the organization to facilitate positive coverage and reimbursement for Sirtex products.

This is a highly accountable and prominent position in Sirtex which requires engagement, partnership, and interaction with colleagues at all levels throughout the Sirtex matrix organization. Of paramount importance to success in the role is close partnership working with cross-functional team colleagues. The candidate should be extremely proactive and highly willing to engage both internally and externally and lead regarding providing successful market access solutions and developing Sirtex’s profile amongst oncology stakeholders of all types. The role demands strong project management experience and confidence in shaping, recommending and implementing strategy and initiatives across Sirtex’s matrix teams.

The candidate is responsible for conducting their activities on behalf of the company consistent with a high standard of business ethics and in compliance with the laws and regulations that govern our activities. The obligation encompasses the following:

  • Takes personal responsibility for and demonstrates a high level of understanding of and adherence to the applicable internal policies, including but not limited to our Code of Ethics.
  •  Adheres to business conduct and other policies applicable to the role, and external laws and regulations governing activities.
  •  Exhibits high business ethics standard in dealing with internal and external stakeholders, including dealing with others honestly and openly, showing accountability, being reliable and trustworthy and being loyal to the company.
  •  Completes all required compliance and ethics related training within required timelines.
  •  Encourages a high level of understanding of and adherence to compliance and ethics amongst colleagues and third parties.
  •  Fully co-operates in any internal and external audits, investigations and inspections.  

RESPONSIBILITIES / AUTHORITIES:

  • Conduct onsite reimbursement meetings for new and existing Sirtex accounts on the current Facility and Professional coding and billing guidelines for the SIRT procedure. Frequency as needed. Track and report customer attendance.
  • Identify the unmet educational needs of keys accounts and work with approved Sirtex tools to provide relevant training and education on coding, billing and Medicare and Medicaid reimbursement.
  •  Develop reimbursement strategies and tactics aligned with Sales leadership that remove coding, coverage and payment barriers for SIRT therapy
  •  Create and present customized CFO value proposition to expand SIRT therapy or to increase utilization in existing treating centers
  •  Develop monthly report of customer activities including regional trends and developments impacting Sirtex US business.
  •  Participate in strategic and tactical planning
  •  Provide input and assist in the development of reimbursement materials and tools for customers and the field team
  •  Audit facility and professional claims as needed
  •  Critically evaluate current procedures and practices. Develop and implement improvements as needed
  •  Strong communication and presentation skills and the ability to translate complex reimbursement information into easy to implement strategies and tactics
  •  Ability to communicate with customers at diverse levels in the organization, from CFO to Billing Clerk
  •  Demonstrate a high standard of work ethic and professionalism to peers and leadership team members at all times
  •  Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
  •  Undergo all formal Training Events as may be directed from time-to-time
  •  Observe and Comply with all Sirtex Corporate Policies
  •  Work within, and ensure adherence to Quality System procedures, work instructions and other Quality System requirements.
  •  Ensure strong alignment between regional business plans and reimbursement and market access activities.
  •   Maintain a deep knowledge and mapping of payer environment, stakeholders and processes for both current and future Sirtex product lifecycles.
  •  Maintain knowledge around Sirtex competitor payer messaging and strategy.
  •  Develop and maintain effective networks with payer stakeholders.
  •  Listens, collects and communicates actionable insights in a systematic way from key (payer) stakeholders, decision makers, competitors, and market trends to shape the value proposition and access strategy
  •  Seek input and alignment with key internal stakeholders at local, regional and if required global level.
  •  Ensure strong alignment between Reimbursement & Market Access and R&D on current and future evidence generation.
  •  Effectively champion the payer value agenda with internal stakeholders.
  •  Listens, collects and communicates actionable insights in a systematic way from key (payer) stakeholders, decision makers, competitors, and market trends to shape the value proposition and access strategy .
  •  Seek input and alignment with key internal stakeholders at local, regional and if required global level.
  •  Ensure strong alignment between Reimbursement & Market Access and R&D on current and future evidence generation.
  •  Effectively champion the payer value agenda with internal stakeholders.

DEVELOPING EXPERTISE:

  • Develop and maintain a high level of knowledge concerning the scientific data that underpins the clinical benefits of Sirtex products and comparator treatments.
  • Develop reference knowledge of related health economic and clinical literature; seek to understand changing customer requirements and the implications of these to support market access throughout the life cycle in key markets.
  •  Maintain and deepen a sound understanding of relevant Reimbursement & Market Access criteria and the likely payer perception of the product value proposition for Sirtex products.
  •  Building and maintaining effective stakeholder relationships (internal and external):
  •  Develop and maintain close working relationships with the internal multidisciplinary regional colleagues.
  •  Undergo all formal Training Events as may be directed from time-to-time.
  •  Observe and comply with all Sirtex corporate policies. 
  •  Work within, and ensure adherence to quality system procedures, work instructions and other quality system requirements.

EDUCATIONAL PREREQUISITES AND SKILL REQUIREMENTS:

  • Bachelor’s Degree required, Master’s Degree in Health Policy or related field preferred.
  • Minimum 10 years in health care reimbursement management
  • Minimum 5 years in private and public payer facing experience (e.g., account management, contract administration, reimbursement management, etc.) Medical device background preferred, oncology and/or interventional radiology experience a plus.
  • Individual must be able to work in a fast paced and demanding environment, capable of managing high pressure situations with both internal and external customers.
  • Strong analytic and investigative skills; able to get to the bottom of an issue.
  • Detail and deadline oriented
  • Skilled in project management, research and data analysis
  • Excellent interpersonal, organizational and communication skills
  • Must be able to travel 60% of the time.

What You Can Expect from Sirtex

If you have the right skills and experience and want to work for a company making a real difference to the quality of people’s lives, Sirtex will offer the right candidate:

  • Diverse and flexible employment and working arrangements to achieve the optimum balance between work and personal responsibilities and objectives
  • A working culture of respect, diversity, and performance to help facilitate an inclusive culture
  • Attractive compensation and benefit packages which are practical, robust, fair and equitable
  • A place to grow through career development and training opportunities
  • Challenging work to continue to develop new and better ways to improve clinical outcomes for oncology treatment around the world.

To apply, please email your cover letter and resume to Human Resources at recruitment@sirtex.com

Sirtex is an Equal Opportunity/Affirmative Action Employer including Disabled/Vets

 

 


Now leaving sirtex.com

You are about to leave the Sirtex Web site. This link is provided to you as a service and will take you to a site maintained by a third party who is solely responsible for the content.

Please be aware that Sirtex takes no responsibility for content of these external sites, nor do we endorse, warrant or guarantee the products, services or information described or offered on other internet sites.

Click 'Continue' to proceed to the third-party Web site.

Continue

×

Now leaving sirtex.com

You are about to leave the Sirtex Website. This link is provided to you as a service and will take you to the Sirtex Virtual Booth.

Sirtex is responsible for the content of the Virtual Booth, which is hosted on a website maintained by a third-party. Except for Sirtex’s Virtual Booth experience, please be aware that Sirtex takes no responsibility for the other content of these external sites, nor do we endorse, warrant, or guarantee the products, services or information described or offered on other internet sites.

Continue

×

You are now leaving your current sirtex.com region

The Sirtex site you are linking to is intended only for healthcare practitioners and patients outside your current region. Any products discussed herein may have different approved product labeling; therefore, any information provided may not be appropriate for use in your region.

Click 'Continue' to proceed to the other Sirtex region Web site.

Continue

×

Effective May 7, 2021, SIR-Spheres will have the following indication for use:
SIR-Spheres Y-90 resin microspheres are indicated for the treatment of unresectable hepatocellular carcinoma (HCC) and unresectable metastatic liver tumors from primary colorectal cancer in patients refractory to or intolerant of chemotherapy.

Click here to view our Technical Bulletin.

Ok