Intuitive Surgical Careers

Senior Health Policy & Reimbursement Manager

US-CA-Sunnyvale, California
Marketing & New Business Development

Job Description

Job: Marketing & New Business Development
Primary Location: United States-California-US-CA-Sunnyvale
Schedule: Full-time
Requisition ID: 181933


Company Description:

Who is Intuitive Surgical? The numbers tell an amazing story. Learn more about our company.

Joining Intuitive Surgical means joining a team dedicated to using technology to benefit patients by improving surgical efficacy and decreasing surgical invasiveness, with patient safety as our highest priority.

ISI is seeking an experienced Manager/Sr. Manager, Health Policy and Reimbursement (specialist) to provide advisory, surveillance and execution of health and medical policy development as it relates to policy, coding, coverage, and reimbursement practices for the U.S. market. While reporting to the Sr. Director, Global Market Access, Health Economics & Payer Relations, this member of the Global Market Access Team will play a key role in working with the U.S. Market Access team via assisting in the development of public/government payer strategies. This person will be responsible for providing operational oversight on the surveillance, monitoring and reporting of all Federal/Private reimbursement policy changes across surgical and diagnostic areas. This person will work with US Marketing Leadership and Regional Market Access Team to identify potential policy/reimbursement issues and implications to the business. Furthermore, this person will collaborate with these teams to appropriately synthesize and/or if needed, help assist in the shaping of public/private policy and the reimbursement implications; including coverage, coding and payment policies for the current marketed and pipeline products.

This position will operate in a fully integrated matrix environment as a full business partner to those U.S. market access and marketing teams. Given the nature of the policy analyses and assisting in preparation of payer engagements, the position will also collaborate with other Global HEOR/HTA/Market Access teams to identify and overcome Payer HTA reviews that could potential impact policy and reimbursement in the U.S. Additionally, this individual will oversee all internal and external customer requests regarding coverage, coding and reimbursement interpretation and education.

Job Description:

• Oversee health and medical policy interpretation, research analyses, and then collaborate with U.S. Market Access team to develop advisory recommendations and go-to-market communication plans for customers that maybe influenced by public/private policy and reimbursement changes.
• Routinely lead and manage surveillance on key health and medical policy issues (i.e. changes to CMS Medicare Part A & B and subsequent IPPS/OPPS/PPFS/IDTF) that may have short- and long-term impacts on ISI technologies or those technologies that we deem competitive or for BD opportunities.
• The individual will focus on understanding the impact of public/government sector trends and initiatives with respect to patient access, reimbursement and quality.
• Additionally they will be responsible for helping translate policy developments into meaningful direction and strategic advisory pieces that include health policy, reimbursement and coding guides so that the U.S. MACA Team may utilize them for dissemination to customers and key stakeholders.
• Assist in providing expertise, management and coordinate coverage, coding, access and reimbursement development for key current and future ISI technologies.
• Assist and lead health and medical policy development with public and private payers.
• Collaborate to develop payer data registries, assets and pilot payer engagement strategies.
• Assist the U.S. MACA team in developing potential reference sites for Custom Hospital Analytics Projects for hospital payer engagement.
• Oversee and manage potential ISI Reimbursement Hotline for internal and external customer inquiries.
• Will be regarded as the coding and reimbursement expert for the U.S. organization and as such will provide updates and educate internal teams with content and dissemination materials as required.

Skill/Job Requirements:

• Broad based general experiences and working knowledge of U.S. market as it relates to health economic intersections within: healthcare systems and hospital providers, surgeons, health technology assessment (HTA) agencies, reimbursement systems and trends that influence technology utilization and adoption from a policy and reimbursement perspective.
• Expertise in U.S. health policy development, reimbursement applications, Federal Register Interpretation and coding changes, development of reimbursement calculations; along with national rates and provider specific rates.
• Experience and comfort in presenting and defending evidence with key clinical and economic decision makers in meetings such CMS/AMA and other agencies that influence health policy and reimbursement decisions.
• Specialist expert understanding of local health/medical policy development, reimbursement practices and financial funds flow analyses from national and private payer payment systems.
• Training and/or experiences in working with health economics, outcomes research, market and patient access strategies, and interaction with KOL, hospital stakeholders and decision makers as it relates to health policy and reimbursement development.
• Lead the efforts with the U.S. Market Access team on developing commercially accepted reimbursement and policy update “leave” behind materials and presentations.
• Performing and overseeing country broad-based economic assessment and highlight meaningful regional influences and trends with little direction.
• Strong reporting, project management, analytical and prioritization skills.
• Results oriented and natural business acumen.
• Self-motivated, self-starter, work independently and can create structure within ambiguity.
• Excellent interpersonal skills.
• Must be able to perform in a fast-paced, results-oriented, diverse cross-functional matrix organization that focuses on a high degree of teaming, both with country and global groups, but balanced with self-directing independent effort.
• Advanced computer skills, including: Microsoft Office, Excel, and PowerPoint, Tableau and statistical software.
• Preferred location: Sunnyvale, CA.
• Must be able to travel in-country 25% of time.
• Bachelor’s degree with 8+ years’ experience or an advanced degree (Masters or Doctorate) with 6+ years’ experience in: health policy, coding/coverage/reimbursement, payer relations, governmental affairs, market access, health economics, or hospital/medical certified coding expert and policy interpreter is required.

We are an AA/EEO/Veterans/Disabled employer.
We will consider for employment qualified applicants with arrest and conviction records in accordance with fair chance laws.