Market Access Policy Operations Manager

Smith & Nephew plc; United States; On-site; USD 120,000 - 155,000; Full time

Benefits offered by this job

401k Matching

Tuition Reimbursement

Flexible Time Off

Volunteer Time

Job summary

Smith+Naphew plc is seeking a Manager of Market Access Policy Operations to lead the operational infrastructure for medical policy intelligence, reimbursement strategy, coding analysis, and market access communications across the organization. You will partner with Market Access, HEOR, Government Affairs, Sales, Marketing, Clinical Affairs, and Regulatory teams to ensure cross-functional alignment.

The role requires 5–10+ years in healthcare reimbursement or market access, with a Bachelor’s

Qualifications

• Bachelor’s degree required; advanced degree preferred.
• 5–10+ years in healthcare reimbursement, market access, policy, or health economics.

Responsibilities

• Lead Medical Policy Intelligence and Coverage Policy operations.
• Monitor and track coverage policies and reimbursement programs.
• Perform coding and reimbursement analysis for products.
• Develop market access communications and training for internal stakeholders.
• Educate internal teams on coverage & reimbursement policy changes.

Skills

Medical policy intelligence

Reimbursement analysis

Coding analysis

Market access

Executive communication

Training & education

Data modeling

Excel

PowerPoint

Medicare/Medicaid policy

CPT/HCPCS knowledge

Education

Bachelor’s degree

Advanced degree preferred

Tools

IQVIA

Policy Reporter

MMIT

Excel

PowerPoint

Job description

Life Unlimited. At Smith+Naphew we design and manufacture technology that takes the limits off living.

Position Summary

The Manager of Market Access Policy Operations is tasked with leading the operational infrastructure that supports medical policy intelligence, reimbursement strategy execution, coding analysis, and market access communications and training throughout the organization. This role acts as a strategic partner to several departments including Market Access, HEOR, Government Affairs, Sales, Marketing, Clinical Affairs, and Regulatory teams, ensuring cross-functional collaboration and alignment.

Primary Responsibilities

• Medical Policy Intelligence
• Monitoring and Tracking Coverage Policy Operations
• Coding and Reimbursement Analysis
• Market Access Communications
• Internal and External Coverage & Reimbursement Policy Education
• Serve as the subject matter expert on coverage, coding, payment, and reimbursement policy.
• Develop and deliver education and training to internal stakeholders including Sales, Market Access, Medical Affairs, Marketing, Compliance, Legal, and Executive Leadership.
• Provide external education to customers, payer stakeholders, and other healthcare audiences regarding reimbursement and coverage of policy developments and implications.
• Translate complex policy changes into actionable business and customer-facing insights.
• Serve as Primary Market Access Contact to Smith+Naphew's Reimbursement Hotline and Patient Access and Reimbursement Managers.
• Maintain Internal Coverage Database to Support Product Coverage.
• Cross-Functional Leadership Operational Excellence Team Leadership.
• Supports reimbursement team communications, marketing materials review and training updates as a subject matter expert.

Qualifications

Candidates for this role are required to have a Bachelor’s degree, with an advanced degree preferred. Additionally, they should possess between 5 to 10 or more years of experience in healthcare reimbursement, market access, policy, or health economics, reflecting a need for substantial expertise in these areas.

Critical Competencies

• Reimbursement Operations
• Coverage Policy Analysis
• Medicare and Medicaid Policy
• Commercial Payer Policy
• Executive Communication
• Demonstrated comprehensive knowledge of coding, coverage, and reimbursement
• Solid understanding of reimbursement methodologies (e.g., hospital inpatient, outpatient, ASC, physician’s office, DME, etc.)
• Understanding of state Medicaid programs and policy development process
• Excellent understanding of medical device industry reimbursement environment (CPT, HCPCS, MAC, LCD, OPPS, MPFS, PDAC, etc.)
• Proven competency in translating complex coverage, coding, and reimbursement policies into clear, actionable training materials and educational programs.
• Must possess strong organizational, analytical, and problem-solving skills with a proven track record of working independently (including the ability to develop data models, identify trends, and generate actionable insights from complex data sets)
• Experience working with medial technology datasets: e.g. IQVIA, Policy Reporter, MMIT, etc.
• Expert in tools and techniques of healthcare business analysis including Microsoft Excel and, Power point and mathematics

Success Measures

• Work independently and excellent time management skills
• Deliver actionable policy intelligence
• Streamline policy monitoring processes
• Improve field readiness
• Support favorable coverage pathways.
• Detail-orientated and data-driven Outstanding oral, written, and interpersonal skills Good business acumen, innovative thinking, and problem-solving skills These metrics focus on operational impact and strategic outcomes within the market access framework.

Travel

Travel: Up to 30% You. Unlimited.

Inclusion and Belonging

We believe in creating the greatest good for society. Our strongest investments are in our people and the patients we serve. Inclusion and Belonging - Committed to Welcoming, Celebrating and Thriving on Belonging, Learn more about Employee Inclusion Groups on our website (https://www.smith-nephew.com/

Your Future

• 401k Matching Program, 401k Plus Program, Discounted Stock Options, Tuition Reimbursement
• Work/Life Balance: Flexible Personal/Vacation Time Off, Paid Holidays, Flex Holidays, Paid Community Service Day
• Your Wellbeing: Medical, Dental, Vision, Health Savings Account (Employer Contribution of $500+ annually), Employee Assistance Program, Parental Leave, Fertility and Adoption Assistance Program
• Training: Hands-On, Team-Customized, Mentorship
• Extra Perks: Discounts on fitness clubs, travel and more!

Compensation

The anticipated base compensation range for this position is around $120,000-$155,000 USD annually. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, geographical location. It is not typical for an individual to be hired at the high end of the range for their role at Smith + Nephew. Compensation decisions are dependent on the facts and circumstances of each position and candidate. In addition to base pay, we provide competitive bonus and benefits, which include medical, dental, and vision coverage, 401k, tuition reimbursement, medical leave programs, parental leave, and generous PTO, paid company holidays annually and 8 hours of Volunteer time and a variety of wellness offerings such as EAP.

Equal Employment Opportunity

Smith+Naphew provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability.

We’re a company of people who care about each other, about our customers and their patients, and about our communities. Together, we fulfill our shared purpose of Life Unlimited.