Reimbursement Specialist

Globus Medical Inc; Collegeville (PA); On-site; USD 65,000 - 90,000; Full time

Job summary

Globus Medical in the United States seeks a Reimbursement Specialist to support payer coverage initiatives and market access activities. You will analyze policies, monitor CMS rulemaking, and partner with Patient Access and Field Sales to enable favorable reimbursement for Nevro products and pipeline.

You will work with internal teams to train sales staff, track policy changes, and identify strategic opportunities in reimbursement. Travel up to 10% is expected.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 1–2 years’ work experience in reimbursement or market access functions.
• Demonstrated working knowledge of the US healthcare system including coverage, coding, and payment policies.
• Travel expectation up to 10%.
• Patient access experience preferred.
• Strong written, verbal, and phone communication skills.
• Customer service / client relations required.
• Advanced Microsoft Excel skills including advanced formulas preferred.
• Demonstrated ability to develop and influence relationships.
• Great interpersonal skills and enjoy interacting with the sales team.
• Solid communication and oral presentation skills.
• Experience in other pharma/biotech functions is a plus.

Responsibilities

• Work with field-based sales team to provide reimbursement-related support (Coding, Billing, Payment, Medical Policy) to customers.
• Assist in providing internal training to sales team and customers, including launching new initiatives or programs.
• Track medical policy changes and other relevant policies applicable to Nevro products and pipeline; share with internal stakeholders.
• Monitor CMS rulemaking and open meetings.
• Research and extract relevant information from secondary data sources to provide strategic insight into market access strategies.
• Interface with Patient Access team (HFX Access) to assist with challenge resolution.
• Establish relationships with key institution/accounts associated with coding, billing, and reimbursement.
• Work cross-functionally with HFX Access, National Accounts, Marketing, Sales, Commercial Operations.
• Stay abreast of macro trends in healthcare that affect product pricing, contracting and distribution.
• Adhere to Code of Conduct and company policies; ensure compliance in all activities.
• Represent the company professionally in all interactions.

Skills

Communication

Customer service

Relationship building

Excel (advanced)

Education

Bachelor’s degree or equivalent

Tools

Microsoft Excel

Job description

Position Summary

At Globus Medical, we move with a sense of urgency to deliver innovations that improve the quality of life of patients with musculoskeletal disorders. Our team is inspired by the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture of exceptional response by partnering with researchers and educators to transform clinical insights into tangible solutions. Our solutions improve the techniques and outcomes of surgery so patients can resume their lives as quickly as possible.

Reporting to the Director, Global Reimbursement, the Reimbursement Specialist will play a vital role supporting projects related to expanding payer coverage, health economic analyses, monitoring healthcare policy trends, and interfacing with customers on various market access initiatives. Additionally, this role will help support the needs of the Patient Access team, HFX Access. The position is part of the Scientific Affairs department and will work in collaboration with various cross-functional partners including HFX Access, Field Sales, Marketing and Clinical Affairs.

Essential Functions

• Work with field-based sales team to provide reimbursement-related support (Coding, Billing, Payment, Medical Policy) to customers.
• Assist in providing internal training to sales team and customers, including launching new initiatives or programs.
• Track medical policy changes and other relevant policies that are applicable to Nevro products and pipeline and share with internal stakeholders Monitor, review and analyze CMS’ annual rulemaking and open meetings.
• Research and extract relevant information from secondary data sources to provide strategic insight into market access strategies.
• Interface with Patient Access team (HFX Access) as appropriate to assist with challenge resolution.
• Establish relationships with key institution/accounts associated with coding, billing, and reimbursement.
• Work cross-functionally with HFX Access, National Accounts, Marketing, Sales, Commercial Operations.
• Stay abreast of macro trends in the healthcare environment that potentially impact current and/or future product pricing, contracting and distribution.
• Adheres to the letter and spirit of the company Code of Conduct, the AdvaMed Code, MedTech Code, and all other company policies.
• Ensures Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally, by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role.
• Represents the company in a professional manner and uphold the highest standards of ethical business practices and socially responsible conduct in all interactions with other employees, customers, suppliers, and other third parties.
• Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• At least 1-2 years’ work experience in reimbursement or market access functions.
• Demonstrated working knowledge of the US healthcare system including coverage, coding, and payment policies by public and private payers.
• Travel expectation up to 10%.
• Patient access experience preferred.
• Strong written, verbal, and phone communication skills.
• Customer service / client relations required.
• Advanced Microsoft Excel skills including advanced formulas preferred.
• Demonstrated ability to develop and influence relationships.
• Great interpersonal skills and enjoy interacting with the sales team.
• Solid communication and oral presentation skills.
• Experience in other functions within the pharmaceutical, biotechnology or related industry is a plus, e.g., field sales, legal, market planning, market or sales analytics, etc.

Physical Demands

The physical demands listed here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Required to sit; climb or balance; and stoop, kneel, crouch or crawl. Required to regularly lift and/or move up to 10 pounds, and occasionally lift and/or move up to 25 pounds. Required to possess specific visons abilities, including close vision, distance vision, color vision, peripheral vision, depth perception and capacity to adjust focus.

Our Values

• PASIONATE ABOUT INNOVATION: Improving patient care by delivering advanced technology to our customers is at the core of what we do. We are passionate in our role in improving the lives of patients by continuously developing better solutions.
• CUSTOMER FOCUSED: We listen to our customers’ needs and respond with a sense of urgency.
• TEAMWORK: Working together, anything is possible. We value every person on our team and treat each other with respect. We are accountable to one another and support each other. Together, we make each other stronger.
• DRIVEN: We pursue our mission with energy and passion. We are nimble, results-oriented and decisive. We overcome obstacles that arise in our quest to deliver solutions that will improve the lives of our customers and patients.

Equal Employment Opportunity

Globus Medical is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, age, disability, marital status, pregnancy, national origin or citizenship. We are committed to a diverse workforce. We value all employees’ talents and support an environment that is inclusive and respectful.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

At Globus Medical, we move with a sense of urgency to deliver innovations that improve the quality of life of patients with musculoskeletal disorders. Our team is inspired by the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture of exceptional response by partnering with researchers and educators to transform clinical insights into tangible solutions. Our solutions improve the techniques and outcomes of surgery so patients can resume their lives as quickly as possible.