Director of Market Access and Reimbursement

• 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.

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

• 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 resolution and business planning.
• Proven effective verbal, computer SW (word, PP etc.), written and presentation/communication skills.
• Ability to quickly adapt and respond to job, environmental, and industry changes.
• Ability to lead others to accomplish work, while monitoring and mentoring them.
• Strong customer service skills, with excellent written & verbal communication skills.
• Strong analytical skills.
• Must be able to communicate effectively & maintain professional conduct at all times.
• Organized, self-starter with the ability to handle numerous projects and prioritize workload with minimal supervision.

• 10%

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Constantly
• Talking - Occasionally
• Hearing - Occasionally
• Repetitive Motions - Frequently

The annual salary for this position is:

This position is eligible for an annual bonus in accordance with the company's bonus plan. Factors which may affect starting salary include geography, skills, education, experience, and other qualifications of the successful candidate. Details of ZOLL's comprehensive benefits plans can be found at www.zollbenefits.com.

Applications will be accepted on an ongoing basis until this position is filled. For fully remote positions, compensation will comply with all applicable federal, state, and local wage laws, including minimum wage requirements, based on the employee’s primary work location.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, or status as a protected veteran.

ADA: The employer will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.