Director, Health Economics & Reimbursement

Aortic stenosis impacts millions of people globally yet it often remains under-diagnosed and under-treated. Edwards groundbreaking work in transcatheter aortic heart valve replacement (TAVR) pioneered an innovative life-changing solution for patients by offering heart valve replacement without the need for open heart surgery. Our Transcatheter Heart Valve (THV) business unit continues to partner with cardiologists and clinical teams to transform patient care with devices supported by clinical evidence. Its our driving force to help patients live longer and healthier lives. Join us and be part of our inspiring journey.

The Director Global Health Economics and Reimbursement is a field-based role responsible for working directly with hospital executives cardiovascular service line leaders and physicians to ensure they recognize the economic and clinical value of the transcatheter heart valve (THV) therapy. They will work directly with hospital leaders and physicians to deliver hospital economic analyses customized to each provider. This individual will also support the health care providers in obtaining optimal reimbursement (payment rates and market access) by serving as a knowledgeable resource in coding coverage and payment as well as an intermediary to payers including Center for Medicare Services (CMS) and/or Medicare Administrative Contractors (MAC) Medicaid Veteran Affairs (VA) and commercial payers.

This role is territory based out of Phoenix or Denver supporting field activity across AZ CO UT and portions of NV WY ID and MT. Candidates must reside in AZ CO or UT with preference given in that order. The role will report to the Sr. Director West Global Health Economics and Reimbursement.

How youll make an impact:

• Ensure THV value messages are consistently developed and delivered and customer feedback on value proposition is communicated to internal THV leadership. This will necessitate a competence in developing synthesizing and presenting health economic analytics.
• Establish and maintain effective working relationships with key stakeholders at hospitals engaged in THV procedures including hospital executives cardiovascular administrators quality finance documentation integrity billing and physicians (interventionists and surgeons) to support the site in establishing and maintaining a THV program through the development and implementation of reimbursement plans (coding coverage payment) unique to each provider.
• Articulate a thorough understanding of the structural heart landscape trends and market insights. A strong understanding of the commercial and government payor landscape including coverage policies and payment processes. This will include managing and addressing coverage policy issues with payors as necessary.
• Understand health economic and quality content: billing coding payment coverage policy hospital finances structural heart program innerworkings cath lab and OR processes clinic and procedural expertise etc.
• Identify needed additional expertise and quickly assimilate information and communicate trends clinical research policies etc. and how they will impact TAVR/Structural Heart business. Identifies market trends and customer needs and supports development of strategies and resources for their customers and team.
• Manage demands and needs of multiple programs and customers. Provide high touch program support and build access to key leaders within each organization.
• Build a strategic relationship and serve as a supporting role to our aligned business partners including sales marketing government affairs and medical/clinical affairs.
• Assist our Regional and Territory Sales Managers in the development implementation and management of strategic initiatives within geography.
• Perform other duties and responsibilities as assigned.

What youll need (Required):

• Bachelors Degree or equivalent in a life science health economics health policy or related field plus 12 years of experience in health policy health economics medical device reimbursement and technology assessment or masters degree plus 10 years of related experience or equivalent work experience based on Edwards criteria.
• Basic understanding of medical and clinical research methodologies including the ability to interpret scientific publications and apply evidence to support product value propositions.
• Demonstrated business acumen and analytical thinking with experience collaborating cross-functionally with teams such as Sales Marketing Clinical Regulatory Legal and Government Affairs to address economic and reimbursement considerations.
• Foundational knowledge of health economics and reimbursement including familiarity with billing coding payment systems coverage policies and hospital financial operations related to structural heart programs and procedures.
• Ability to travel up to 50% domestically

What else we look for (Preferred):

• Minimum of 5 years of work experience in a field based consultative or administrative role within the healthcare industry.
• Reimbursement and/or sales experience.
• Strong understanding of the commercial insurance landscape and relevant reimbursement processes. A solid understanding of public payer programs e.g. CMS including coverage coding and payment policies.
• Ability to build and maintain strong relationships with hospital leaders and physician customers.
• Proficient in Microsoft Office Suite (i.e. Excel PowerPoint Word Outlook).
• Excellent interpersonal skills written and verbal communication skills especially presentation development and delivery in person and virtually. Must be confident articulate and have professional speaking abilities.

Aligning our overall business objectives with performance we offer competitive salaries performance-based incentives and a wide variety of benefits programs to address the diverse individual needs of our employees and their families.

For Colorado (CO) the base pay range for this position is $174000 to $246000 (highly experienced).

The pay for the successful candidate will depend on various factors (e.g. qualifications education prior experience). Applications will be accepted while this position is posted on our Careers website.

Edwards is an Equal Opportunity/Affirmative Action employer including protected Veterans and individuals with disabilities.

COVID Vaccination Requirement

Edwards is committed to protecting our vulnerable patients and the healthcare providers who are treating them. As such all patient-facing and in-hospital positions require COVID-19 vaccination. If hired into a covered role as a condition of employment you will be required to submit proof that you have been vaccinated for COVID-19 unless you request and are granted a medical or religious accommodation for exemption from the vaccination requirement. This vaccination requirement does not apply in locations where it is prohibited by law to impose vaccination.