Summary:

The Director, Health Economics & Reimbursement (HE&R) is responsible for strategy and all evidence generation to meet US and international value, access, and payment policy objectives. This role will be based in the US and will collaborate closely on US and global evidence generation and find opportunities to leverage evidence across varied country payment processes and policies. In partnership with the VP, Health Economics and Reimbursement, this role will lead a broad range of healthcare projects including health economic modeling, prior authorization and denial management The cross functional project teams may include Sr Executives within the Company, clients, members of the Office of Medical Affairs, Marketing, Clinical and Regulatory to achieve deliverables.

Responsibilities:

• Develop and lead HE&R strategies and work plan to support product strategy and position in partnership with product teams.
• Work in conjunction with the VP, Health Economics and Reimbursement and Sr Executives in researching and developing reimbursement tools for hospital and physician clients.
• Contribute to the design, HE&R endpoint selection, reporting and analysis of clinical studies including subgroup analyses.
• Design and implement recommended HE&R solutions
• Execute on the HE&R plan by designing, developing, and completing HE&R -led studies that support commercialization strategies and demonstrate value to key stakeholders.
• Typical project areas include (but not limited to) developing hospital specific margin analyses, clinical trial reimbursement support, managing customer denial and appeals management.
• Supply data and/or quantitative information that develops project findings and recommendations.
• Provide detailed, quantitative analysis; build Excel models; and prepare operational and financial projections.
• Prepare client-ready deliverables and present complex findings to non-technical audiences.
• Work with the larger teams and take lead on presentation of final deliverables that go to client sponsors.
• Leverage existing registries and databases to support regulatory requirements, address Health Technology Assessment (HTA)/payer evidence generation.
• Contribute and provide leadership to clinical, HE&R and economic studies across geographies and communication activities to advance market access and reimbursement goals.
• Work closely with medical affairs and product development to provide recommendations and rationale for evidence generation plans in terms of economic, patient-centric and real-world effectiveness data.

Requirements:

• A Bachelor’s degree or Masters degree in Public Health, Healthcare Administration or Business Administration, with an emphasis in data analysis, data grouping and large data sets.
• 10+ years of applicable professional experience in health plan or medical device industry and/or healthcare consulting experience.
• Significant knowledge of the healthcare industry.
• Experience in value-based payment arrangements such as Medicare Advantage/Managed Care, risk contracting, shared savings arrangements, and/or post-acute care consulting.
• Experience developing analytical models and structuring methodologies.
• Excellent quantitative analysis skills and strong data analytics background (financial modeling/planning skills a Plus).
• Possess strong and influential leadership skills with proven ability to lead internal and external team members at all levels.
• Demonstrated management of smaller work streams or deliverables.
• Strategic and conceptual thinker and planner.
• Proficiency with Excel, including experience in formatting, formulas, pivot tables, etc.
• A team player that fosters a culture of collaboration and team-oriented process.
• Ability to travel 25%.