Director, Payer Relations - Shockwave

Johnson & Johnson; Teletrabalho; BRL 727.000 - 1.252.000; Tempo integral

Resumo da oferta

A leading healthcare company is seeking a Director of Payer Relations - Shockwave to manage relationships with payers and strategize reimbursement processes. This remote position requires extensive experience in healthcare coding and coverage, with a focus on developing successful payer relations. Ideal candidates will demonstrate expertise in influencing policies and maximizing patient access to medical devices. The role offers a competitive salary range and excellent benefits, including medical coverage and a generous leave package.

Serviços

Medical, dental, and vision insurance

401(k) retirement plan

Generous paid time off

Qualificações

• 7–10 years of healthcare coding, coverage, and reimbursement experience with medical devices.
• Experience with Medicare and commercial payer policies.
• Strong understanding of clinical and economic data, coding, coverage, and payment issues.

Responsabilidades

• Develop and manage strategic relationships with health plans and payers.
• Lead development of payer coverage and reimbursement strategies.
• Monitor and analyze payer coverage policies and trends.

Conhecimentos

Healthcare coding

Reimbursement experience

Communication skills

Analytical skills

Formação académica

Bachelor’s degree in public policy, health economics, or life sciences

Master’s degree

Ferramentas

Microsoft PowerPoint

Microsoft Excel

Microsoft Word

Descrição da oferta de emprego

At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at https://www.jnj.com

Job Function: Market Access

Job Sub Function: Health Economics Market Access

Job Category: People Leader

All Job Posting Locations: Dallas, Texas, United States; Horsham, Pennsylvania, United States of America; Irvine, California, United States of America; New Brunswick, New Jersey, United States of America; New York, New York, United States; Palm Beach Gardens, Florida, United States of America; Raynham, Massachusetts, United States of America; Santa Clara, California, United States of America; Titusville, New Jersey, United States of America

Job Description

Johnson and Johnson is currently seeking the best talent for a Director, Payer Relations - Shockwave within the Johnson & Johnson MedTech organization.

This is a field-based remote role available in all states/cities within the United States. While specific cities are listed in the Locations section for reference, please note that they are examples only and do not limit your application. We invite candidates from any location to apply.

Role Overview

The Director of Payer Relations is responsible for developing and managing strategic relationships with national and regional health plans and other third-party payers. This role ensures that Shockwave Medical’s products are positioned favorably with payers, networks, and reimbursement structures to maximize patient access and organizational revenue. The individual will also partner cross-functionally with members of the sales, marketing, and clinical affairs teams to inform the long-term evidence strategy required to obtain and maintain reimbursement in U.S. markets.

Key Responsibilities

• Lead the development and execution of national and regional payer coverage and reimbursement strategies, including clinical data and publication requirements, health economics, and general value proposition models, to ensure successful payer negotiations, commercial viability, and improved patient access to covered IVL indications.
• Engage with third-party evidence review organizations to ensure up-to-date reviews of Shockwave clinical data and provide education and materials in support of positive conclusions from clinical literature.
• Develop and maintain strong relationships with target payers and build a working knowledge of their key processes including medical policy, utilization review, health outcomes, risk management, provider contracting, and claims processing.
• Develop relationships with Advisory Committee members and payer Medical Directors (key influencers for our indications) for public and private payers to support changes that reflect local medical practices.
• Influence policy development such as new Local Coverage Determinations (LCDs) and engage with various coverage advisory groups to enhance patient access.
• Effectively leverage and communicate published literature and other evidence to payers, demonstrating IVL value that positively influences coverage policy development.
• Monitor payer coverage policies, track review periods, and analyze data on medical review, prior authorization, and claims payment trends to inform payer strategy, tactics, and team priorities.
• Collaborate with Field Reimbursement Managers as needed for ongoing strategy execution.
• Support Clinical Education with lead local physician advocates to influence payer coverage and medical review policies.
• Improve effectiveness and focus of industry alliances, as needed, that support Medicare and commercial payer policy and patient access.
• Provide internal and external voice-of-customer (VOC) feedback to guide strategy development.
• Develop programs to train Sales Representatives and key economic customers on reimbursement issues.
• Perform other duties as assigned.

Qualifications

• Bachelor’s degree in public policy, health economics, or life sciences required; Master’s degree preferred.
• 7–10 years of healthcare coding, coverage, and reimbursement experience with medical devices; vascular or coronary experience is a plus.
• Experience with complex reimbursement areas including Medicare and commercial payer policies and processes.
• Demonstrated success in developing coverage for emerging technologies and influencing payer policies.
• Strong understanding of clinical and economic data, coding, coverage, and payment issues.
• Expertise in reimbursement principles across various healthcare settings (physician offices, hospitals, ambulatory surgery centers).
• Willingness to travel 25–50% as required.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft PowerPoint, Excel, and Word.

Base Pay Range

Applicable Pay Range Bay Area: $168,000 - $271,400 ; US Country Norm: $137,000 - $235,750

Pay Transparency

Please use the following language: Subject to the terms of their respective plans, employees and/or eligible dependents are eligible to participate in the following Company sponsored employee benefit programs: medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance. Subject to the terms of their respective plans, employees are eligible to participate in the Company’s consolidated retirement plan (pension) and savings plan (401(k)). This position is eligible to participate in the Company’s long-term incentive program. Subject to the terms of their respective policies and date of hire, Employees are eligible for the following time off benefits: Vacation –120 hours per calendar year Sick time - 40 hours per calendar year; for employees who reside in the State of Washington –56 hours per calendar year Holiday pay, including Floating Holidays –13 days per calendar year Work, Personal and Family Time - up to 40 hours per calendar year Parental Leave – 480 hours within one year of the birth/adoption/foster care of a child Condolence Leave – 30 days for an immediate family member: 5 days for an extended family member Caregiver Leave – 10 days Volunteer Leave – 4 days Military Spouse Time-Off – 80 hours Additional information can be found through the link below. https://www.careers.jnj.com/employee-benefits