Senior Manager, Payer Relations & Value-Based Offerings
Boston Scientific
Additional Location(s): N/A
Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance
At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions.
About the role:
This Senior Manager, Payer Relations & Value-Based Offerings is responsible for supporting Boston Scientific’s senior level strategic relationships with national and regional United States (U.S.) health plans, including integrated delivery network (IDN)-owned health plans. The Senior Manager is responsible for securing market access and coverage for targeted Boston Scientific Neuromodulation portfolio of products with payers and provider organizations. Develops and executes business plans for payer stakeholders, within defined territory, to positively advocate and remove barriers to access and to ensure coverage and reimbursement for Boston Scientific procedures and devices. Payer stakeholders include commercial private and public payers (Health Plans, Medicaid, Medicare, Health Systems), selected complex provider systems and other market influencers. Partners and collaborates with internal and external stakeholders to understand the barriers to access to BSC Neuromodulation technologies. This position will report to the Director, Health Policy & Health Economics, Neuromodulation.
Location: This is a field-based, remote position with up to 75% travel. Will consider any location across the United States.
Your responsibilities will include:
- Managing and leading the development and implementation of national and regional payer activities for BSC Neuromodulation franchise with corporate and divisional staff and key internal and external stakeholders.
- Actively participating in development and execution of practical strategies to secure optimal coverage for BSC products and procedures.
- Executing strategies and tactics for reimbursement and access within targeted local and regional plans for key technologies.
- Leading implementation of tactical planning activities required to achieve strategic coverage objectives including payer team tools, provider access tools, sales team messaging, etc.
- Identifying key health coverage needs for BSC platform products, working with divisional counterparts and health economics and outcomes research colleagues to determine actions required.
- Assessing coverage opportunities and challenges facing the division’s emerging technologies and commercially marketed products.
- Collaborating with leader of national Payer Relations and Corporate Accounts team to leverage partnership discussions whenever possible to support coverage activities and to share contacts and best practices.
- Monitoring policy developments that impact the coverage of BSC products.
- Developing patient access and payer trending reports from data pulled internal prior authorization portal(s).
Required qualifications:
- A bachelor’s degree (B.A. or B.S.) is required; advanced degree is preferred.
- A minimum of 10 years of experience working on coverage determination and utilization management within medical device or commercial payer organization.
- Established network of Medical Directors and health insurance plans (AHIP, NAMCP, etc.)
- Experience with Medicare and Medicaid coverage strategy.
- Deep knowledge of healthcare, managed care strategy, pricing and the medical reimbursement environment required.
- Prior strategic account management responsibilities or equivalent relationship development or consulting experience with one of the following: payers, government agencies, IDNs, Accountable Care Organizations (ACOs).
- Proven ability to successfully interact with the C-suite, society leaders, and key opinion leaders.
- Platform presentation skills that make this individual a desired speaker at industry events in front of large groups.
- Proven track record of influence management within a matrix environment.
- Proven ability of successfully managing complexity, solving problems, and building strong relationships.
- Ability to work well independently as well as collaboratively; self-motivated and disciplined to meet deadlines in the context of competing priorities and projects; lead and work effectively with cross-functional teams.
- Ability to maintain and effectively deal with highly confidential matters.
- Proven ability in working with commercial organizations, ensuring timely engagement and customer support of internal and external customers.
- Computer literacy (Microsoft Office Suite), including high level of competency in Excel and Salesforce and have high level skillset to develop and analyze reports.
- Ability to understand clinical evidence and apply the evidence to develop clinical based responses regarding coverage policies.
- Must be able to travel up to 75% as dictated by business need.
Preferred qualifications:
- Experience with neuromodulation-based procedures including pain, interventional spine and brain.
- Highly organized with ability to effectively manage multiple priorities in a fast-paced environment.
- Strong written and oral communication skills.
- Well-developed strategic and analytical skills.
- Ability to model and live BSC’s corporate values.
Requisition ID: 597600
Minimum Salary: $129800
Maximum Salary: $246600
The anticipated compensation listed above and the value of core and optional employee benefits offered by Boston Scientific (BSC) – see www.bscbenefitsconnect.com--will vary based on actual location of the position and other pertinent factors considered in determining actual compensation for the role. Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs. At BSC, it is not typical for an individual to be hired near the bottom or top of the anticipated salary range listed above.
Compensation for non-exempt (hourly), non-sales roles may also include variable compensation from time to time (e.g., any overtime and shift differential) and annual bonus target (subject to plan eligibility and other requirements).
Compensation for exempt, non-sales roles may also include variable compensation, i.e., annual bonus target and long-term incentives (subject to plan eligibility and other requirements.
For MA positions: It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability.
As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most – united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do – as a global business and as a global corporate citizen.
So, choosing a career with Boston Scientific (NYSE: BSX) isn’t just business, it’s personal. And if you’re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!
At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve.
Boston Scientific Corporation has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, the Company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and all other personnel decisions are made and administered without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identify, gender expression, veteran status, age, mental or physical disability, genetic information or any other protected class.
Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.