About This Role

Reporting to the Senior Director, Health Economics & Outcomes Research, the Director, Government Programs & Reimbursement is responsible for building a data-driven access and reimbursement strategy and execution roadmap to support iRhythm’s continued growth and expansion. This role is focused on maximizing access of existing and future portfolio by engaging with CMS, medical and professional societies to shape the marketplace; generating evidence-driven initiatives to improve policy on a national and regional level with both private and public payers; and, relatedly, collaborating to inform internal HEOR/clinical evidence generation strategies. To achieve these goals, the Director must be skilled at collaborating cross-functionally to ensure appropriate market access, policy, and reimbursement needs and incorporated into business planning early and often.

Role Responsibilities

Lead and Execute Organizational Access & Reimbursement Strategies

• The Director is responsible for leading the development, modeling, execution and measurement of access and reimbursement strategies to maximize market adoption, accelerate product launches, and maximize lifecycle management.
• Work closely with cross-functional partners in Clinical, Health Economics, Payer Relations, Payer Marketing to collaborate and develop value propositions supporting portfolio development that resonate with employers, payers, and providers.

Lead Incorporation of Access & Reimbursement Considerations into Product Development

• Collaborates with business units to provide critical reimbursement input to ensure appropriate market access, policy, and reimbursement perspectives are integrated into business plans.
• Work with business and product development teams to ensure reimbursement needs are incorporated into product development timelines.
• Review business development opportunities from an access and reimbursement perspective ensuring coverage and pricing potentials of the assessed opportunity.

Collaborate with Regulatory to Incorporate Access Considerations into FDA Submissions and Post-Market Studies

• Collaborate with regulatory partners to ensure FDA regulatory submissions are aligned with organizational ability to achieve reimbursable access now and the in the future
• Contribute to achieve accordance between regulatory outcomes and perception of value from a payer, provider, and health system perspective.

Lead Advancement of iRhythm’s Policy Agenda

• Champion health policy agenda as it pertains to coverage and access for existing and new products across lines of business including CMS, Commercial, Medicare Advantage, State Medicaid, and Managed Medicaid plans.
• Partner with Clinical, HEOR, Marketing, Market Access and Medical Affairs teams to align Brand and Product-specific evidence generation, value strategy, development of dossier, etc.
• Lead the Centers for Medicare & Medicaid Services (CMS) proposed rule-making notice and comment processes on all annual comment opportunities, working closely with partners across the businesses to ensure our comments represent iRhythm current and future portfolio.
• Collaborate strategically with VP and Directors of Market Access & Payer Relations using territory insights and analysis to improve access/coverage through evidence-driven initiatives.
• Monitor and provide reimbursement and federal health policy-related guidance and updates to product development teams, marketing, sales, regulatory, clinical, and business leaders to influence business decisions

Support Market Shaping Activities in Support of iRhythm Strategic Agenda

• Developing sustainable strategic relationships with governmental decision makes (CMS), medical associations (HRS, ACC, AHA), professional associations (AMA), thought leaders, trade groups and patient advocacy groups to provide leadership and focus in areas of mutual interest to influence outcomes of critical market access issues.
• Lead work alongside other senior health policy experts within relevant trade associations (e.g. AdvaMed, AI Coalition) and other member companies to provide feedback on iRhythm’s behalf as principles, policy and advocacy positions are developed.

Candidate Background

• Degree in medicine, pharmacy, life sciences, economics, or epidemiology.
• A postgraduate degree such as Masters, MPH, or PhD in Health Outcomes, Health Economics, or Health Services.
• Minimum of 10 years’ experience in CMS (Medicare Medicaid) Market Access or related field
• Deep understanding of the business of healthcare and hospital/physician provider operations
• Strong understanding of global payer markets, market access issues, with demonstrable track record.
• Strong written, verbal, oral and presentation skill
• Exceptional analytic and writing skills.
• Proven ability to contribute to a team and deliver results on time with available resources, within budget.
• Proven ability to work on multiple projects and with multiple individuals simultaneously.
• Proven ability to maintain high quality output.
• Experience and knowledge with Medicare, Medicaid, and Commercial payers

Desired Characteristics

• Exceptional written and verbal communication skills along with the ability to effectively present technical data and complex concepts to diverse audiences
• Ability to apply knowledge of healthcare systems, global health technology appraisals requirements, and clinical development, to identify evidence gaps and propose evidence generation strategies
• A track record of success functioning in dynamic, matrix environments with the ability to multitask seamlessly
• Strong attention to detail and quality focused

What's In It For You

This is a regular full-time position with competitive compensation package, excellent benefits including medical, dental, and vision insurances (all of which start on your first day), health savings account employer contributions (when enrolled in high deductible medical plan), cafeteria plan pre-taxed benefits (FSA, dependent care FSA, commute reimbursement accounts), travel reimbursement for medical care, noncontributory basic life insurance & short/ long term disability. Additionally, we offer:

• emotional health support for you and your loved ones
• legal / financial / identity theft/ pet and child referral assistance
• paid parental leave, paid holidays, travel assistance for personal trips and PTO!

iRhythm also provides additional benefits including 401(k) (with company match), an Employee Stock Purchase Plan, pet insurance discount, unlimited amount of Linked In Learning classes and so much more! 

FLSA Status: Exempt

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