Senior Manager, Reimbursement Operations & Field Market Access - ION

Core Responsibilities

• Provider-Facing Billing Guide Development: Create, maintain, and distribute comprehensive billing and coding guides for all products. Ensure guides are CPC-reviewed, compliance-approved, and updated with each code cycle.
• Customer Reimbursement Support: Serve as the primary point of contact for management of customer reimbursement vendor(s). Manage vendor, monitor performance, and retain required documentation.
• Code Implementation Logistics: Manage all field logistics associated with the implementation of new or existing CPT, HCPCS, and ICD-10 codes. Coordinate with provider sites to ensure smooth adoption of coding changes and cost capture.
• Sales & Marketing Support: Generate evidence-driven, compliant field collateral in direct support of the sales and marketing organization.
• Payer-Facing Value Dossier Development: Coordinate with Upstream and distribute value dossiers and payer-facing evidence packages that communicate the clinical and economic value of the product portfolio.
• Key Account Management: Manage fractional headcount resources and coordinate payer engagement at key accounts.
• Policy Monitoring & Implementation: Track payer coverage policies, MAC LCDs, and commercial payer guidelines. Translate upstream payment policy developments into actionable field tools and communications.
• Field Personnel Management for Payer Campaigns: Manage and direct field personnel in support of payer-focused campaigns. Coordinate field reimbursement specialists, outsourced resources, and account-level teams to execute payer engagement strategies, coverage initiatives, and pull-through programs at targeted accounts.
• Shared Midstream / Payment Policy Code Acquisition Support: Support CPT/HCPCS code acquisition activities in partnership with the Upstream Strategist, including preparation of supporting materials for AMA and CMS submissions.
• Payment Policy Implementation: Translate CMS OPPS/PFS payment policy changes into operational guidance for the field. Develop communications for code changes, payment updates, and coverage determinations.
• Reimbursement Calculator & Tools: Develop and maintain compliance-accurate reimbursement estimation tools for use by the sales team and provider accounts.

Qualifications

• 4 year degree is required. 6+ years of progressive experience in medical device or pharmaceutical reimbursement, field market access, or payer relations.
• Direct experience developing billing guides, coding tip sheets, and provider reimbursement education materials.
• Strong working knowledge of CPT, HCPCS, ICD-10 coding systems and hospital billing workflows (OPPS, ASC, physician office).
• Experience managing payer relationships, developing value dossiers, and executing advisory boards.
• Demonstrated ability to work closely with sales and marketing teams in a commercial support capacity.
• Strong project management skills; ability to manage multiple simultaneous deliverables across products.
• CPC (Certified Professional Coder) certification strongly preferred.
• Experience with field reimbursement team management (outsourced or in-house).
• Familiarity with FCA/AKS compliance requirements for manufacturer-provided reimbursement guidance.
• Experience with business intelligence platforms.