Senior Manager, Operations – Market Access

This is a fully remote position, open to applicants in California.

📋 Description

• Develop, maintain, and disseminate extensive billing and coding manuals for all products.

• Ensure that all guides are reviewed by CPC, approved for compliance, and updated with each coding cycle.

• Act as the main point of contact for overseeing customer reimbursement vendors.

• Manage vendors, assess performance, and maintain necessary documentation.

• Oversee field logistics for the implementation of new or existing CPT, HCPCS, and ICD-10 codes.

• Collaborate with provider sites to facilitate coding adoption and cost capture.

• Produce evidence-based, compliant field materials for sales and marketing purposes.

• Coordinate and distribute value dossiers along with payer-facing evidence packages.

• Manage fractional headcount resources and facilitate payer engagement at key accounts.

• Monitor payer coverage policies, MAC LCDs, and guidelines from commercial payers.

• Convert developments in payment policy into field tools and communications.

• Oversee and direct field personnel for campaigns focused on payers.

• Coordinate field reimbursement specialists, outsourced resources, and account-level teams.

• Assist in CPT/HCPCS code acquisition efforts and prepare materials for AMA and CMS submissions.

• Translate CMS OPPS/PFS payment policy changes into operational directives.

• Create communications regarding code changes, payment updates, and coverage determinations.

• Develop and sustain compliant reimbursement estimation tools for sales teams and provider accounts.

• Initially share midstream/payment policy responsibilities with the Upstream Strategist, transitioning to a downstream focus upon the hiring of a dedicated Midstream resource.

⛳️ Requirements

• A bachelor's degree is required.

• A minimum of 6 years of progressive experience in medical device or pharmaceutical reimbursement, field market access, or payer relations.

• Direct experience in creating billing guides, coding tip sheets, and educational materials for provider reimbursement.

• Strong working knowledge of CPT, HCPCS, ICD-10 coding systems, and hospital billing workflows (OPPS, ASC, physician office).

• Experience in managing payer relationships, developing value dossiers, and conducting advisory boards.

• Proven ability to collaborate closely with sales and marketing teams in a commercial support role.

• Excellent project management skills; capable of managing multiple concurrent deliverables across various products.

• CPC (Certified Professional Coder) certification is strongly preferred.

• Experience managing field reimbursement teams (either outsourced or in-house).

• Familiarity with FCA/AKS compliance requirements for manufacturer-provided reimbursement guidance.

• Experience with business intelligence platforms.

• Candidates may be subject to U.S. export-control licensing or a Technology Control Plan.

• Current proof of vaccination against specific diseases may be required.

🏝️ Benefits

• Remote work; employees are required to come onsite when requested by their leader.

• Incentives.

• Comprehensive benefits.

• Equity opportunities.

• Reasonable accommodations for qualified individuals with disabilities.

• Potential vaccination coverage requirements for certain diseases, including COVID-19.