Senior US Market Access & Reimbursement Strategist

SmartRecruiters, Inc.; Sunnyvale (CA); On-site; USD 208,000 - 312,000; Full time

Job summary

Intuitive Surgical is seeking a Principal US Market Access and Reimbursement Specialist to lead pre‑launch US reimbursement strategy for Future Forward growth platforms. You will work with Clinical Affairs, Regulatory Affairs, HEOR, and R&D to define optimal pathways and ensure coding, coverage, and payment considerations shape study design and regulatory strategy.

The role demands deep CPT/HCPCS/ICD‑10 coding expertise, Medicare methodologies, and experience with innovative payment pathways.

Qualifications

• Minimum 15 years of related experience in US market access, reimbursement, coding, or health policy roles within medical device, biotech, consultancy, payer, or hospital settings with a bachelor's degree.
• Bachelor’s degree required; advanced degree (MS, MBA, MPH, PhD, or equivalent) preferred.
• AAPC Certified Professional Coder (CPC) or equivalent strongly preferred and highly valued; candidates without certification should demonstrate equivalent working fluency in procedural coding and a willingness to obtain CPC within 12 months of hire.
• Track record of developing and executing US reimbursement strategy for novel or first‑of‑kind procedural technologies, from early pipeline through launch, and of personally producing the underlying reimbursement analyses, coding assessments, and payer policy reviews rather than directing a team.
• Demonstrated experience with CMS innovative payment pathways (NTAP, TPT, NT‑APC), including at least one application taken through to decision.
• Experience working directly with Clinical Affairs and Regulatory Affairs on device programs, including contributing reimbursement input to study design, endpoint selection, indication wording, or FDA pathway decisions.

Responsibilities

• Define and own the US reimbursement strategy for each Future Forward growth platform, including pathway selection, sequencing, timelines, and critical dependencies; advise senior leaders on the trade‑offs and decision points for programs with ambiguous or novel payment pathways.
• Independently conduct detailed analyses of CPT, HCPCS Level II, and ICD‑10‑CM/PCS code applicability for growth platform procedures, including crosswalk and analog selection, bundling and modifier logic, and NCCI edits, and defend the rationale to internal and external stakeholders.
• Track and interpret CMS rule‑making cycles (OPPS, MPFS, IPPS proposed and final rules) and translate implications for platform reimbursement.
• Analyze APC assignment, RVU values, payment rates, and packaging logic to identify reimbursement risks and opportunities across hospital outpatient, ASC, and physician office settings.
• Assess MAC LCDs, NCDs, and commercial payer policies for existing coverage signals and likely coverage barriers relevant to growth platforms ahead of launch.
• Lead the development of NTAP, TPT, and NT‑APC applications for eligible growth platform technologies.
• Monitor CMS pathway eligibility criteria, application windows, and approval precedents to identify strategic opportunities.
• Build and maintain reimbursement scenario analyses comparing standard payment versus innovative pathway scenarios.
• Track competitor and adjacent‑technology applications and outcomes to inform Intuitive’s pathway strategy.
• Partner with HEOR colleagues on the evidence requirements that support innovative payment pathway submissions.

Skills

Coding knowledge

Health economics

Strategic thinking

Independent working style

Education

Bachelor’s degree

Advanced degree preferred

CPC certification preferred

Tools

CMS policy

FDA pathways

Job description

Intuitive Surgical is seeking a Principal US Market Access and Reimbursement Specialist to lead pre‑launch US reimbursement strategy for Future Forward growth platforms. You will work with Clinical Affairs, Regulatory Affairs, HEOR, and R&D to define optimal pathways and ensure coding, coverage, and payment considerations shape study design and regulatory strategy.

The role demands deep CPT/HCPCS/ICD‑10 coding expertise, Medicare methodologies, and experience with innovative payment pathways.