Senior Manager, Market Access & Reimbursement
GE HealthCare · Waukesha, WI · 2 days ago
Hybrid$146k–$218k/yrFull-time
Key Responsibilities
- Lead the development and execution of U.S. market access and reimbursement strategies to secure, maintain, and expand payer coverage for icobrain.
- Serve as the subject matter expert and strategic lead for reimbursement, partnering cross-functionally to drive business outcomes.
- Develop and execute commercial payer account plans to support coverage, coding, and payment optimization.
- Actively engage with payers to educate on icobrain’s value proposition and influence coverage decisions.
- Maintain expertise in regional MAC and CMS policy changes and their impact.
Payer & Stakeholder Engagement
- Establish and maintain relationships with key stakeholders, decision makers, and influencers across major payer organizations.
- Collaborate with Evidence Generation/HEOR and Clinical teams to deliver compelling value propositions, clinical evidence, and economic models to payers and providers.
- Partner with U.S. Advocacy to build relationships with patient advocacy groups, physician KOLs, and medical societies to support patient access.
- Work closely with the Field Commercial team to address reimbursement questions, provide guidance, and remove access barriers.
Reimbursement Education & Support
- Design and deliver targeted reimbursement and coding education to support payer engagement and provider adoption strategies.
- Develop educational materials, including manuals, presentations, and e-learning modules.
- Serve as a resource for coding and reimbursement-related questions across teams and customers.
Compliance, Coding & Policy Expertise
- Maintain deep expertise in ICD-10-CM, CPT, HCPCS, and payer-specific guidelines.
- Conduct coding audits and provide insights to improve accuracy and compliance.
- Stay current with CMS regulations, payer updates, and industry best practices.
- Partner with clinical documentation improvement (CDI) teams to enhance provider documentation.
Cross-Functional Leadership
- Lead initiatives and drive alignment across cross-functional stakeholders without direct reporting authority.
- Influence internal teams including Commercial, Clinical, HEOR, and Advocacy to support access strategies and business objectives.