Regional Manager Payor Accounts - Midwest

Bausch & Lomb GmbH; Central (LA); Hybrid; USD 140,000 - 185,000; Full time

Benefits offered by this job

Incentives (ST/LT)

Medical, dental, vision insurance

401(k) with company match

Tuition reimbursement (select degrees)

Company holidays

Well-being benefits

Paid time off

Job summary

Regional Manager Payor Accounts - Midwest at Bausch + Lomb seeks a senior professional to drive payor strategy, secure coverage and manage reimbursement for MIGS products. Extensive field engagement and travel are required to build payer relationships and influence policy.

Responsibilities include collaborating with Sales, educating providers, and serving as the reimbursement SME across Medicare Advantage and Medicaid in the Midwest region. Travel is 30%-50%, 3 nights/week on average.

Qualifications

• Bachelor's degree required; advanced life science, business or ophthalmology experience preferred.
• 5+ years in payor/reimbursement roles within medical devices and Part B coverage.
• 2+ years in ophthalmic practice management, practice billing, and revenue cycle.
• Ability to interpret MAC LCDs and CMS articles related to MIGS for Medicare Advantage.
• Proven payor strategy, reimbursement and account management experience; product launch experience a plus.
• Deep knowledge of Commercial, Medicare and Medicaid reimbursement structures, coding, billing and appeals.

Responsibilities

• Develop and execute regional payor strategies to secure and maintain coverage, coding and reimbursement.
• Partner with Sales to educate and support customers by removing access barriers and resolving reimbursement challenges.
• Conduct reimbursement seminars on local payor coverage criteria and requirements.
• Build relationships with payor medical directors, state agencies and advocacy organizations to influence policy.
• Serve as the regional payor expert for MIGS reimbursement, guiding internal teams and customers on processes.
• Engage with key healthcare stakeholders across Commercial, MedAdv and Medicaid as needed.

Skills

Payor strategy

Reimbursement

Account management

Stakeholder engagement

Medicare/Medicaid knowledge

CMS regulations interpretation

Education

Bachelor's degree

Job description

Regional Manager Payor Accounts - Midwest

Bausch + Lomb (NYSE/TSX: BLCO) is a leading global eye health company dedicated to protecting and enhancing the gift of sight for millions of people around the world—from the moment of birth through every phase of life. Our mission is simple, yet powerful: helping you see better, to live better.

Our comprehensive portfolio of over 400 products is fully integrated and built to serve our customers across the full spectrum of their eye health needs throughout their lives. Our iconic brand is built on the deep trust and loyalty of our customers established over our 170-year history. We have a significant global research, development, manufacturing and commercial footprint of approximately 13,000 employees and a presence in approximately 100 countries, extending our reach to billions of potential customers across the globe. We have long been associated with many of the most significant advances in eye health, and we believe we are well positioned to continue leading the advancement of eye health in the future.

Objective:

The Regional Account Manage-Market Access (RAM) will execute the payor strategy within an assigned region to secure and maintain favorable coverage, coding, and reimbursement across commercial plans, Medicare Advantage (MedAdv), and Medicaid in assigned states. This role reports to the National Payor Account Director (East / West) and will drive access for Surgical Glaucoma products, influence payer policy, and enable provider adoption and patient access. This role will establish and maintain payor relationships, i.e., Medical Director and medical policy staff, resolving reimbursement barriers, and ensuring appropriate and consistent payment.

The RAM will also serve as a reimbursement liaison as needed and collaborate with cross-functional colleagues in Sales, Medical Affairs, and the HUB provider to educate physicians and institutional customers in local payor policy requirements. RAM-Glaucoma will serve as a subject-matter expert in regional payor policy for MIGS devices for medical benefit. The RAM will proactively engage with medical directors, state agencies, and advocacy groups in the assigned region to build sustainable coverage pathways and support future technologies B+L brings to the market. Extensive field engagement and travel required.

Responsibilities:

• Develop and execute regional payor strategies to secure and maintain coverage, coding, and reimbursement across Commercial, Medicare Advantage and Medicaid as required.
• Partner with Sales teams to educate and support customers by removing access barriers and resolve complex reimbursement challenges.
• Conduct reimbursement seminars via videoconference or in person on local payor coverage criteria and requirements for appropriate reimbursement of B+L Surgical Glaucoma products.
• Build and sustain relationships with payor medical directors, state agencies, and advocacy organizations to influence policy and coverage decisions.
• Serve as the regional payor and reimbursement subject-matter expert for assigned payors - guiding internal teams and customers on medical device reimbursement, coding, billing, and appeals processes.
• Understand and work with key health care stakeholders within the following customers: Commercial Managed Care (Regional Plans), Medicare Advantage (MedAdv), Medicaid (Fee for Service) as needed, State Ophthalmic Medical Groups, State Advocacy, patient, provider, and other key healthcare stakeholder groups.

Qualifications:

• Bachelor's degree required, advanced degree in life science, business and ophthalmology experience preferred.
• 5 plus years of industry experience in payor/reimbursement roles within medical devices and Part B coverage
• Minimum 2 years’ experience in ophthalmic practice management, practice billing, and revenue cycle, public or private third-party reimbursement related to MIGS and their impact on providers, ASCs, and hospitals.
• Ability to interpret MAC LCDs and Articles related to MIGS and seek enforcement of CMS regulations as they pertain to Medicare Advantage plans.
• Proven experience with payor strategy, reimbursement, and account management; direct product launch experience highly desirable
• Deep knowledge of Commercial, Medicare, and Medicaid reimbursement structures, coding (i.e., CPT, ICD-10 codes), billing, and appeals processes.
• Strong executive presence and stakeholder engagement skills with payors, KOLs, hospital systems
• Highly organized, self-directed, ability to work with ambiguity and effective in cross-functional environments.
• Able to travel extensively (30% - 50% / ~ 3 nights/week)

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

For U.S. locations that require disclosure of compensation, the starting pay for this role is between $140,000.00 and $185,000.00. The estimated salary range reflects an anticipated range for this position. The actual base salary offered may depend on a variety of factors.

• U.S. based employees may be eligible for short-term and/or long-term incentives.
• They may also be eligible to participate in medical, dental, vision insurance, disability and life insurance, a 401(k) plan and company match, a tuition reimbursement program (select degrees), company holidays, and well-being benefits, among others.
• U.S. based employees are also eligible to receive sick time, floating holidays and paid vacation.

Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.