Regional Payor Lead - Ophthalmic MIGS Devices (Remote)

Bausch+Lomb; United States; Remote; USD 110,000 - 150,000; Full time

Job summary

Bausch + Lomb is seeking a Regional Account Manager - Market Access (RAM) to execute payor strategies and secure coverage for MIGS devices across the assigned region. You will build relationships with payor medical directors and state agencies to influence policy and enable patient access.

The role requires 5+ years in payor/reimbursement within medical devices, plus knowledge of CMS guidelines and CPT/ICD-10 coding.

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.

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.

Skills

Payor strategy

Reimbursement

Account management

CMS regulations

Stakeholder engagement

Education

Bachelor's degree

Life sciences/related advanced degree

Job description

Bausch + Lomb is seeking a Regional Account Manager - Market Access (RAM) to execute payor strategies and secure coverage for MIGS devices across the assigned region. You will build relationships with payor medical directors and state agencies to influence policy and enable patient access.

The role requires 5+ years in payor/reimbursement within medical devices, plus knowledge of CMS guidelines and CPT/ICD-10 coding.