Patient Access & Reimbursement Manager

Patient Access and Reimbursement Manager
As part of the Advanced Wound Management (AWM) Market Access + Reimbursement department the Patient Access and Reimbursement Manager (PARM) will support Smith and Nephew’s (S+N) BioTissue, Negative Pressure Wound Therapy (NPWT) Sales teams and customers to help navigate the patient access and reimbursement landscape to S+N products (Grafix, Oasis, and dNPWT – PICO and Renasys).
We have 3 openings due to growth:
Regions: applicant must be near a major airport

• Chicago: Chicago and suburbs
• Northern California: Sacramento, San Fran Bay
• Texas: DFW, Houston

Responsibilities:

• Execute field reimbursement strategies by providing HCP on-boarding education, adherence to compliance guidelines, sharing of approved reimbursement resources, providing effective communication and by developing strong internal partnerships to provide Patient Access + Reimbursement education related to H.O.P.D. and P.O. setting reimbursement.
• Serve as the primary reimbursement subject matter expert supporting the field sales team in all areas related to access and reimbursement of AWM products.
• Respond to changes in CMS guidelines by teaching customers to navigate non-clinical barriers to treatment.
• Work with the field sales team to educate on proper reimbursement methodologies when the S+N portfolio is used in atypical places of service (i.e. home health, skilled nursing facilities, assisted living, etc.).
• Serve as the primary contact for reimbursement education for new and existing customers on billing, coding, educate on how to submit various claim forms for the first time, based on place of service, national and local coverage policies, and accurate and sufficient clinical documentation for S+N products.

Qualifications:

• Bachelors degree or relevant experience
• 3+ years of buy and bill medical benefit reimbursement experience
• Experience with Salesforce based CRM systems preferred
• Familiarity with medical policy for insurance payers. Strong understanding of CMS and final-rules and methodologies, experience with multiple places of service requirements, comprehension of Commercial Insurers (Aetna, Anthem Blue Cross Blue Shield, Cigna, Humana, United Health Care)

Competencies:

• Ability to work independently in a fast paced, demanding environment, with great attention to detail
• Ability to lead-without-authority and adherence to all compliance requirements in a highly sensitive area of the business

Travel Requirements: Up to 50%
All professionals that are required to gain entry into healthcare facilities to perform the basic remit of their role, must successfully complete our credentialling process, which includes COVID 19 vaccine management.
Our Company
Smith & Nephew is a portfolio medical technology company founded in 1856 and is headquartered in Watford, the United Kingdom. It is a constituent of the UK's FTSE100; shares are traded on the London Stock Exchange. It has over 17,500 employees, operates in over 100 countries with over $5B revenue in 2019.
Our global franchises
Orthopaedics: Orthopaedics includes an innovative range of Hip and Knee Implants used to replace diseased, damaged or worn joints, robotics-assisted enabling technologies that empower surgeons, and Trauma products used to stabilize severe fractures and correct bone deformities.
Sports Medicine & ENT: Our Sports Medicine and Ear, Nose and Throat (ENT) businesses offer advanced products and instruments used to repair or remove soft tissue. They operate in growing markets where unmet clinical needs provide opportunities for procedural and technological innovation.
Advanced Wound Management: Our Advanced Wound Management portfolio provides a comprehensive set of products to meet broad and complex clinical needs, to help healthcare professionals get CLOSER TO ZERO human and economic consequences of wounds.
Our Cultural Pillars are CARE, a culture of empathy and understanding for each other, our customers and patients, COLLABORATION, a culture of teamwork, based on mutual trust and respect, and COURAGE, a culture of continuous learning, innovation and accountability.
At Smith+Nephew, we offer competitive and rewarding compensation and benefits packages!
Our benefits packages vary from country to country and by level, but often the total package includes the following:

• Strong Healthcare coverage.
• A competitive company retirement benefit scheme for all employees.
• A competitive salary with an annual bonus plan.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
Smith+Nephew provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability.
Smith+Nephew provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability.