Regional Manager Payor Accounts - Midwest

Bausch & Lomb GmbH; United States; Sur place; USD 140 000 - 185 000; Plein temps

Avantages offerts par ce poste

Medical insurance

Dental insurance

Vision insurance

401(k) with company match

Tuition reimbursement program

Company holidays

Well-being benefits

Paid vacation

Résumé du poste

Bausch + Lomb is seeking a Regional Manager Payor Accounts for the Midwest to lead payor strategy for Surgical Glaucoma products. The role focuses on securing coverage, coding and reimbursement across Commercial, Medicare Advantage and Medicaid in assigned states.

Extensive field engagement and travel are required. The RAM will collaborate with Sales, Medical Affairs, and HUB to educate physicians and institutional customers on payor policy requirements and to build sustainable coverage

Qualifications

• Bachelor's degree required; life science or business preferred.
• 5+ years in payor/reimbursement in medical devices with Part B coverage.
• Minimum 2 years’ experience in ophthalmic practice management, practice billing, and revenue cycle.
• Ability to interpret MAC LCDs and CMS regulations as they pertain to Medicare Advantage.
• Proven payor strategy, reimbursement, and account management experience.

Responsabilités

• Develop and execute regional payor strategies to secure and maintain coverage and reimbursement.
• Partner with Sales to educate and support customers by removing access barriers.
• Conduct reimbursement seminars on local payor coverage criteria for MIGS products.
• Build relationships with payor medical directors and state agencies to influence policy.
• Serve as regional payor expert guiding internal teams on reimbursement, coding and appeals.
• Engage with Commercial, Medicare Advantage, Medicaid and other stakeholders in the region.

Connaissances

Payor strategy

Reimbursement

Account management

Strategic communication

Healthcare policy

Formation

Bachelor's degree

Description du poste

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.