Head of Market Access & Reimbursement Strategy

Company Overview:

Saluda is a global healthcare company that is redefining Spinal Cord Stimulation (SCS) therapy at the intersection of automated algorithms, real-time diagnostics, and ground-breaking clinical evidence. The Saluda difference is defined by Dose-Control Technology via measurement of physiological response.

At Saluda, we challenge boundaries. We innovate and think beyond the conventional. We disrupt. With the passion and energy of an accomplished team of seasoned experts, our focus is to revolutionize the standard of care in the neuromodulation space by transforming the lives of patients suffering from debilitating pain.

The Role: 

The Head of Market Access & Reimbursement Strategy plays a critical role in the development and execution of patient access, reimbursement and adoption strategies globally. As a subject matter expert with proven track record of functional success, the Director will inform access policy with support and collaboration with key constituencies within and outside of the company. He or she will engage with key decision makers and have demonstrated expertise working with agencies including the U.S. Center for Medicare & Medicaid Services, and private payers. Working closely with internal stakeholders, this individual will further inform product development, from conception and throughout the product development life cycle. In addition, the role will be responsible for managing a patient access program, driving differentiation in the field through market access initiatives, and monitoring government policy changes.

Responsibilities:

• Collaborate with the Commercial leadership team in developing reimbursement strategies based on Marketing, Legal, Clinical and Regulatory parameters to drive reimbursement requirements.
• Manage, retain, and grow a team responsible for Reimbursement, Market Access, and government policies. Analyze health care policy to ensure the environment supports the adoption of Saluda system and the pipeline of technologies to come.
• Leading development and execution of practical strategies to secure optimal reimbursement for Saluda Medical products and procedures.
• Leading implementation of tactical planning activities required to achieve health economics and reimbursement strategic objectives (e.g., preparation of economic and reimbursement dossiers for payer negotiations, new code applications, customer billing guides).
• Setting up, managing, and evolving the prior authorization service, including developing the business case for investment and working with cross-functional teams to implement changes.
• Manage provision of reimbursement support to sales force and key external stakeholders (e.g., hospitals, clinicians, investigator sites, professional societies) as appropriate.
• Assess reimbursement opportunities and challenges facing emerging technologies/indications and commercially marketed products and communicate business impact to executive leadership.
• Work with new product development teams to ensure health economics and reimbursement needs are incorporated into product development plans and timelines; ensure all necessary new product development deliverables are completed on time and on budget.
• Manage provision of appropriate in-service training to sales, marketing, clinical, regulatory, and legal to increase awareness and understanding of health economics and reimbursement competencies and their role in supporting a product’s success.
• Access Policy & Rule Making: Monitor health policy and regulatory developments that impact the reimbursement of Saluda’s products. Inform and collaborate with internal and external stakeholders in the formation of access policies affecting divisional and portfolio interests.
• Global Access Support & Thought Partnership: Understand and anticipate global requirements, supporting data development and value analyses relevant to diverse economic stakeholders, payer archetypes and ecosystems globally.
• S. CMS Expertise: Proactively engage in the U.S. CMS rule making process, work through others including Government Affairs and medical societies to support activities including reimbursement and rate setting, value-based health care initiatives, demonstration projects, insurance coverage and analyses, and related Medicare, State Medicaid, as well as U.S. Military Health initiatives while informing business planning and decision making.
• Reimbursement Publication Planning: Contribute to the development of clinical and economic outcomes research, value analyses and publications relevant to access strategies across the portfolio and pipeline.
• Stakeholder Engagement: Build relationships in key markets with government, physician, hospital, societies, and third-party payer influencers and decision makers.
• Stakeholder Education & Awareness: Lead functional educational and awareness campaigns relevant to internal and external stakeholders.
• Value Analyses & Messaging: Collaborate with cross-functional teams in the development and communication of economic value messages to support product adoption.
• Product Development: Provide functional input to portfolio and business development decisions to ensure health economics and market access needs are incorporated into product development plans and timelines; ensure all necessary new product development deliverables are completed on time and on budget.
• Inform Strategic Pricing: Support strategic pricing activities in collaboration with commercial leaders within the neuromodulation division.
• Functional Leadership & Representation: Actively participate within leadership teams and communities of interests, presenting information and strategies aligned with business plan expectations.

Essential Requirements:

• Bachelor’s degree required, advanced degree preferred (e.g. JD, MD, MBA, MHP, etc.).
• Minimum 10+ years of functional experience
• Experience within the medical device market space preferred
• Experience working with U.S. public health authorities, including CMS and private payers
• Experience working with national and regional, commercial health plans, third party utilization management organizations, HTAs as well as U.S. integrated delivery care systems and payer archetypes.
• Strong understanding of data and operational requirements of the economic stakeholder.
• Demonstrated ability to develop and execute access strategies for innovative medical technologies.
• Good working knowledge of U.S. hospital, ambulatory surgery center and physician office financial and practice management systems.
• Strong interpersonal and people leadership skills.
• Demonstrated ability to collaborate cross functionally, and across a matrixed organization achieving qualitative and quantitative business results.

Saluda Medical embraces diversity and equal opportunity. We are committed to building a team representative of a variety of backgrounds, perspectives and skills. We believe people are the source of our inspiration and innovation.

Saluda Medical does not accept non-solicited resumes or candidate submittals from search/recruiting agencies not already on Saluda Medical’s approved agency list. Unsolicited resumes or candidate information submitted to Saluda Medical by search/recruiting agencies not already on Saluda Medical’s approved agency list shall become the property of Saluda Medical.