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Philips Field Director Reimbursement in United States of America - Home Based, Massachusetts

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We welcome you to join Philips Image Guided Therapy Devices (IGT-D) as a Field Director Reimbursement – home-based location.

If you are a Colorado resident and this role is a field-based or remote role, you may be eligible to receive additional information about the compensation and benefit package for this role, which we will provide upon request. You may contact 888-367-7223, option 5, for assistance.

US work authorization is a precondition of employment within the US. The company will not consider candidates who require sponsorship for a work-authorized visa.

In this role, you have the opportunity to

The Field Reimbursement Director will work closely with the field sales team to execute reimbursement strategy for Philips IGTD current and future products and procedures. This includes all aspects of coverage, coding, payment, and provider access within hospitals, ambulatory surgery centers, OBL’s, and the physician offices.

This position will be a field-based professional on reimbursement issues and will coordinate field strategies to improve market access to Philips IGTD products and procedures.

Primary responsibilities include developing relationships with public and commercial payor partners to expand coverage; communicating with Key Opinion Leaders to champion efforts to expand patient access; coding strategies at the account level to remove barriers to product utilization; educating customers on appropriate coding related to Philips IGTD products and procedures and strategizing with the regional sales team to improve market adoption.

The position typically requires at least 50% travel but may be as much as 75% travel.

You are responsible for

Lead strategies to expand market access to Philips IGTD products and procedures

  • Develop and maintain collaborative relationships with Medicare contractors and commercial payors (including Medical Directors, Policy Analysts, Case Managers, Provider Relations Representatives, etc.) to acquire positive coverage decisions that include adequate payment

  • Develop and maintain relationships with KOLs and state professional society leadership to support reimbursement efforts

  • Identify and actualize opportunities to expand market access through specialty distributors, GPOs, integrated health plans, and Technology Assessment Organizations/Committees

  • Identify and establish strategic relationships with large employers or employer groups and patient advocacy organizations to expand patient and provider access to Philips IGTD portfolio

  • Develop and maintain a comprehensive understanding of regional and local reimbursement coverage issues through payor research, face-to-face meetings, KOL interviews and attendance at public meetings

Facilitate coverage and payment for Philips IGTD products and procedures

  • Provide strategic support to current customers to resolve coverage denials and/or empower improved contract negotiations to facilitate economically viable payment

  • Provide internal and external recommendations regarding coding for related services consistent with Philips market approval processes

  • Delivers presentations to payers to establish and/or improve reimbursement coverage policies, coding and payment assignments utilizing available resources:

  • Attend regional or national professional society meetings as needed to educate current and potential customers on reimbursement issues and to gain support for market access through policy development

Collaborate with sales team to drive market access

  • Work cross-functionally within field sales, sales management, and marketing to improve pull­-through and demonstrate available resources

  • Provide market feedback to corporate management on customer business trends, competitive updates and industry issues and opportunities

  • Serve as a strategic business partner with field sales leadership to prioritize in regional work plan for payor and physician education through frequent communication and quarterly business reviews

  • Identify and establish relationships with multiple buying influences at account level, especially within the facility C-suite and develop action plans to advance their understanding and support of Philips IGTD products and procedure portfolio. Educate, train and support field sales and internal partners on reimbursement-related issues, including coverage, coding, and payment

  • Secure and increase number of payor’s covered lives for all product lines

  • Participate in regional and national sales meetings and local/regional marketing events as needed

  • Travel with field sales team members to support and educate customers with identified reimbursement challenges and to gain support for payor education strategies through policy and/or clinical guideline development

Daily Activities Include

  • Provide accurate and current information to Philips IGTD customers to support field sales through management of reimbursement issues and programs, interpretation of policy and training of physicians, facilities and staff members in reimbursement and coding

  • Assist customers with achieving appropriate reimbursement and understanding reimbursement tactics for meeting payer requirements for documentation of medical necessity

  • Respond to coverage, coding, and payment inquiries from providers by offering objective information based upon qualified and recognized reimbursement sources that may assist the physician in making an informed coding determination based on the procedure to be performed with a Philips device

  • Track payer/provider trends by geography

To succeed in this role, you should have the following skills and experience

  • Bachelor (BA/BS) degree and 10+ years of demonstrated ability in reimbursement / healthcare policy development

  • Demonstrated knowledge and experience in payer (Medicare, Medicaid, and Private) policies, reimbursement process and the health care legislative environment

  • Knowledge of managed care and health insurance industry

  • Experience in interacting efficiently with payer decision-makers, health care reimbursement professionals and local carrier medical directors

  • Experience in using clinical data to support reimbursement position in presentations

  • Knowledge of health care provider issues related to reimbursement and practice economics

  • Experience working with organizational decision makers – marketing, regulatory and sales managers

  • Experience working directly with sales representatives

  • Experience working with reimbursement strategies and tactics

  • Working knowledge of computer software including Word, Excel, PowerPoint and MS Project

  • Project management skills

  • Ability to travel to payer and prospective customer/customer sites

  • Ability to follow and implement policies and procedures required of this position

  • Detailed knowledge of insurance companies including government payers (Medicare, Medicaid, Tricare) and private payers (PPOs and HMOs) with regard to professional and facility payment systems

  • Effective communication and presentation skills, strong telephone skills

  • Attention to detail

  • Well-organized, self - motivated

  • Occasional weekend work commitment

Why should you join Philips?

Working at Philips is more than a job. It’s a calling to create a healthier society through meaningful work, focused on improving 3 billion lives a year by delivering innovative solutions across thehealth continuum. Our people experience a variety of unexpected moments when their lives and careers come together in meaningful ways. Learn more bywatching this video

Find out more info about Philips at www.philips.com/na/careers

It is the policy of Philips to provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to race, color, ethnicity, religion, gender, pregnancy/childbirth, age, national origin, sexual orientation, gender identity or expression, disability or perceived disability, genetic information, citizenship, veteran or military status or a person’s relationship or association with a protected veteran, including spouses and other family members, marital or domestic partner status, or any other category protected by federal, state and/or local laws.

As an equal opportunity employer, Philips is committed to a diverse workforce. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants that require accommodation in the job application process may contact 888-367-7223, option 5, for assistance.

Equal Employment and Opportunity Employer/Disabled/Veteran

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