Regional Payor Strategy Manager — Glaucoma

Bausch + Lomb; Boston (MA); On-site; USD 120,000 - 180,000; Full time

Job summary

Bausch + Lomb is seeking a Regional Account Manager–Market Access (RAM) to lead payor strategy for MIGS devices across the assigned region. You will secure coverage, coding, and reimbursement by engaging with commercial plans, Medicare Advantage, and Medicaid, and you will collaborate with Sales, Medical Affairs, and HUB to educate providers and institutional customers.

The role requires deep knowledge of CPT/ ICD-10, CMS regulations, and state policy; travel 30-50%; and strong stakeholder

Qualifications

• Bachelor's degree required; advanced degree preferred in life science, business, or ophthalmology.
• 5+ years in payor/reimbursement within medical devices.
• 2+ years in ophthalmic practice management or related reimbursement roles.
• Ability to interpret MAC LCDs and CMS regulations for Medicare Advantage.
• Proven payor strategy, reimbursement and account management experience.
• Knowledge of CPT, ICD-10 codes, billing, and appeals.

Responsibilities

• Develop and execute regional payor strategies to secure 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 Commercial Managed Care, Medicare Advantage, Medicaid, State Ophthalmic Medical Groups, State Advocacy, patient, provider, and other key healthcare stakeholder groups.

Skills

Payor strategy

Reimbursement experience

Ophthalmic reimbursement

Medicare/Medicaid knowledge

MAC LCD interpretation

Account management

Travel readiness

Stakeholder engagement

Education

Bachelor's degree

Advanced degree in life science

Advanced degree in business

Ophthalmology experience

Job description

Bausch + Lomb is seeking a Regional Account Manager–Market Access (RAM) to lead payor strategy for MIGS devices across the assigned region. You will secure coverage, coding, and reimbursement by engaging with commercial plans, Medicare Advantage, and Medicaid, and you will collaborate with Sales, Medical Affairs, and HUB to educate providers and institutional customers.

The role requires deep knowledge of CPT/ ICD-10, CMS regulations, and state policy; travel 30-50%; and strong stakeholder