Manager - Reimbursement, Health Economics & Market Access

Job Description

Job Description

Salary :

The Manager of Reimbursement, Health Economics and Market Access (RHEMA) will be a critical member of PRIAs RHEMA team, reporting directly to Sr. Leadership in RHEMA. This role will conduct reimbursement research and other consulting activities within the RHEMA team for PRIAs client base, with a focus on coverage, coding, payment and policy research, while staying abreast of key policy decisions within the healthcare ecosystem.

This role will also execute reimbursement strategies, under the direction of the Sr. Leadership teams at PRIA, in particular with coding, coverage and payment execution, including interviews with payers and providers; and preparation and presentation of client deliverables. This position may also be filled at the Senior Manager level, depending on experience.

Responsibilities

• Conduct primary research independently and manage and interact with clients with minimal supervision.
• Prepare deliverables (in Microsoft Office and other programs) that summarize research of RHEMA teamand present implications and recommendations for clients.
• Present project findings to clients with minimal assistance from senior leaders.
• Present research and findings to colleagues and clients.
• Management of projects content review and development, timelines and budgets; connecting policy and payment research to definitive recommendations for clients.
• Manage and lead applications and interactions with CMS, including for NTAP, TPT, New Tech APC, HCPCS and ICD-10 applications.
• Manage and lead applications and interactions with specialty societies and AMA pertaining to CPT.
• Manage and lead applications and interactions with PDAC pertaining to HCPCS code verification.
• Stay abreast of key reimbursement and market access policy issues impacting clients.
• Oversee ongoing monitoring and knowledge development of assigned policy and therapeutic areas.
• Utilize knowledge in healthcare reimbursement systems to be a resource to colleagues and clients.
• Lead project teams of peers and junior staff.
• Own responsibility for the quality of deliverables.
• Own responsibility for developing and confirming strategy recommendations with minimal assistance from senior leaders.
• Participate, as needed, on business development and proposal generation.

Required Qualifications

Compensation & Benefits