November 7, 2024

Kerecis

Arlington

FULL TIME

Director of Medical Policy

Description: The Director of Medical Policy works with the Medical Strategy and Knowledge Advancement team, Sales, and Field Reimbursement team to pursue payor contacts to maximize insurance coverage and payment rates for Kerecis products. In this role, the Director reviews Payor Policy cycles and payment rate negotiations, and work with Clinical Affairs to extend Kerecis insurance coverage. The role works in close collaboration with the Medical Affairs, Market Access, Field Reimbursement and Benefits Investigations teams to execute strategic plans.
This position works in a Kerecis office and directly report to the Senior Vice President of Medical Strategy and Knowledge Advancement.
Responsibilities

Manage a strategy to engage Private Payers, Medicare and Medicaid and other strategic payor organizations to expand coverage and access to Kerecis technologies
Document the actions from internal Policy meetings, follow up, and hold accountable the assigned task managers
Manage tasks assigned to consultants
Attend the Alliance for Wound Care Stakeholders meetings, document the meetings, send notes internally manage medical policy reviews, contract additions and requests
Identify opportunities for innovative partnerships with private insurers and other strategic healthcare organizations.
Develop and maintain high-value relationships with key decision makers
Maintain thorough knowledge of political climate, market trends and contracting needs.
Conduct regular business reviews with private insurers.
Consult on market access and reimbursement strategy for new and emerging products.
Support Medical Strategy and Knowledge Advancement in Training events
Work cross functionally within Kerecis to achieve MBO targets and goals
Other duties and tasks as assigned

Requirements: Competencies

Strong project management, presentation, communication and financial analysis skills
Relevant scientific, technical and consultative sales training
Ability to work effectively with cross-functional teams in a fast-paced, multi-dimensional organization
Superior communication and presentation skills

Education & Experience

Bachelor’s degree in a Scientific or Business discipline
3 years related experience in healthcare medical device industry
Track record of successfully working with health care payors and other strategic healthcare organizations
Relevant advanced degrees and/or healthcare certifications, preferred
Proven track record of working for or with health care payors and other strategic healthcare organizations
Strong established relationships with hospitals in a designated area

Travel: frequent (50%)
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time. Kerecis LLC is an equal opportunity employer.